Affect Regulation,

Mentalization,
a n d t h e D e v e l o p m e n t of the Self
 / A f f e c t R e g u l a t i o n ,

M e n t a l i z a t i o n ,

a n d t h e D e v e l o p m e n t o f t h e S e l f ,

Peter Fonagy
Gyorgy Gergely
Elliot L. Jurist
Mary Target

m
OTHER
Other Press
New York
3 7

H S

o o 2

Copyright © 2002 by Peter Fonagy. Gy6rgy Gergely. Elliot L. Jurist, and Mary Target
This book was set in ITC Bookman.
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Library of Congress Cataloging-ln-Publicatlon Data
Affect regulation, mentalization and the development of the self / by Peter Fonagy
... [et al.].
p. cm.
Includes bibliographical references and index.
ISBN 1-892746-34-4
1. Affective disorders. 2. Affect (Psychology). 3. Self, I. Fonagy, Peter. 1952-
RC537 -A283 2002
616.89—dc21 2001058026
 C o n t e n t s

ABOUT THE AUTHORS vii

ACKNOWLEDGMENTS xi

INTRODUCTION

PARTI
THEORETICAL PERSPECTIVES

CHAPTER 1
Attachment and Reflective Function:
Their Role in Self-Organization 23

CHAPTER 2
Historical and Interdisciplinary Perspectives
on Affects and Affect Regulation 65

CHAPTER 3
The Behavior Geneticist's Challenge to a Psychosocial Model
of the Development of Mentalization 97
vi / Contents

PART II
DEVELOPMENTAL PERSPECTIVES

CHAPTER 4
The Social Biofeedback Theory of Affect-Mirroring:
The Development of Emotional Self-Awareness
and Self-Control in Infancy 145

CHAPTER 5
The Development of an Understanding of Self and Agency 203
CHAPTER 6
"Playing with Reality": Developmental Research
and a Psychoanalytic Model for the Development of Subjectivity 253
CHAPTER 7
Marked Affect-Mirroring and the Development
of Affect-Regulative Use of Pretend Play 291

CHAPTER 8
Developmental Issues in Normal Adolescence
and Adolescent Breakdown 317

PART III
CLINICAL PERSPECTIVES

CHAPTER 9
The Roots of Borderline Personality Disorder
in Disorganized Attachment 343
CHAPTER 10
Psychic Reality in Borderline States 373
CHAPTER 11
Mentalized Affectivity in the Clinical Setting 435
EPILOGUE 469

REFERENCES 481
INDEX 549
 About the Authors

Peter F o n a g y , Ph.D., F.B.A., is F r e u d Memorial Professor of

Psychoanalysis a n d Director of t h e S u b - D e p a r t m e n t of Clinical
Health Psychology a t University College London. He is Director of
t h e Child a n d Family Center a n d of t h e Clinical O u t c o m e s Re-
s e a r c h a n d Effectiveness Center, b o t h a t t h e Menninger F o u n d a -
tion, K a n s a s . He is also Director of Research a t t h e A n n a Freud
Centre, London. He is a clinical psychologist a n d a training a n d
supervising a n a l y s t in t h e British Psychoanalytical Society in
child a n d a d u l t analysis. He is Chair of t h e Research Committee
a n d Vice-President of t h e International Psychoanalytic Associa-
tion, a n d a Fellow of t h e British Academy. He is on t h e editorial
board of a n u m b e r of major j o u r n a l s , including Development and
Psychopathology a n d t h e Bulletin of the Menninger Clinic. He h a s
p u b l i s h e d over 2 0 0 c h a p t e r s a n d articles a n d h a s a u t h o r e d or
edited several books. His m o s t recent b o o k s include What Works
for Whom: A Critical Review of Psychotherapy Research (with A.
Roth; p u b l i s h e d in 1996 by Guilford Press), Psychoanalysis on
the Move: The Work of Joseph Sandler (coedited with A. Cooper
a n d R. Wallerstein; p u b l i s h e d in 1999 by Routledge), Attachment
Theory and Psychoanalysis (published in 2 0 0 1 by O t h e r Press),
a n d Evidence-Based Child Mental Health: A Comprehensive Re-
view of Treatment Interventions (with M. Target, D. Cottrell, J .
Phillips, a n d Z. Kurtz; to b e p u b l i s h e d by Guilford Press).
vii
viii / About the Authors

Gydrgy Gergely, Ph.D., is Director of t h e Developmental Psy-

chology Laboratory of t h e Psychology I n s t i t u t e of t h e H u n g a r i a n
Academy of Sciences a n d Senior Lecturer a t t h e Cognitive Devel-
opmental Doctoral Program of t h e E6tvos Lorand University in
Budapest. He is a clinical psychologist a n d is o n t h e visiting
faculty of t h e Max P l a n c k I n s t i t u t e for Psychology in M u n i c h , t h e
Child a n d Family Center a t t h e Menninger Clinic, t h e Depart-
m e n t of Psychology a t University College London, a n d t h e De-
p a r t m e n t of Psychology a t Berkeley. He is on t h e Panel of t h e
E u r o p e a n Cognitive Neuroscience Initiative a t Trieste, Italy. He is
t h e a u t h o r of Free Word Order and Discourse Interpretation (pub-
lished in 1991 by Academic P r e s s of Budapest) a n d h e serves on
the editorial b o a r d s of several major j o u r n a l s .

Elliot L. Jurist, Ph.D., Ph.D., is a Professor in t h e D e p a r t m e n t

of Philosophy, Hofstra University, a n d a Lecturer in t h e Depart-
m e n t of Psychiatry, College of Physicians a n d Surgeons, Colum-
bia University. He is t h e a u t h o r of Beyond Hegel and Nietzsche:
Philosophy, Culture and Agency (published in 2 0 0 0 by MIT Press)
a n d of n u m e r o u s articles in philosophy a n d psychoanalysis. He
is a Member of t h e Neuropsychiatry Service, New York Presbyte-
rian Hospital, a n d a Member of t h e Ethics Committee of t h e New
York S t a t e Psychiatric Institute.

Mary Target, Ph.D., is a Senior Lecturer in Psychoanalysis a t

University College London a n d a n Associate M e m b e r of t h e Brit-
ish Psychoanalytical Society. S h e is D e p u t y Director of Research
a t the A n n a F r e u d Centre, Member of t h e C u r r i c u l u m a n d Scien-
tific Committees, C h a i r m a n of t h e Research Committee of t h e
British Psychoanalytical Society, a n d C h a i r m a n of t h e Working
Party o n Psychoanalytic E d u c a t i o n of t h e E u r o p e a n P s y c h o a n a -
lytic Federation. S h e is C o u r s e Organizer of t h e UCL Master's
Course in Psychoanalytic Theory a n d Academic C o u r s e Organ-
izer of t h e UCL/Arma F r e u d Centre Doctorate in Child a n d
Adolescent Psychotherapy. S h e is on t h e editorial b o a r d of sev-
eral j o u r n a l s , including t h e International Journal of Psycho-
Analysis, a n d s h e is J o i n t Series Editor for psychoanalytic books
a t WhuiT Publishers a n d a n Associate Editor for t h e New Library
of Psychoanalysis, Routledge. S h e h a s active r e s e a r c h collabora-
 About the Authors / ix

t i o n s in m a n y c o u n t r i e s in t h e a r e a s of developmental p s y c h o p a -
thology a n d p s y c h o t h e r a p y outcome. S h e is a u t h o r a n d editor of
several books, including Attaccamento e Funzione Riflessiva (with
P. Fonagy, p u b l i s h e d in 2 0 0 0 by Raffaello Cortina Editore of
Milan) a n d The Outcomes of Psychoanalytic Treatment (edited
with M. Leuzinger-Bohleber; to b e p u b l i s h e d b y Whurr).
 Acknowledgments

We would like to acknowledge first of all o u r g r a t i t u d e to o u r

patients; s o m e of t h e ideas in t h i s book h a v e b e e n p r o m p t e d by
o u r clinical work, a n d one i m p o r t a n t yardstick in j u d g i n g t h e
ideas is w h e t h e r t h e y c a n help u s better to u n d e r s t a n d o u r
experiences w i t h p a t i e n t s p a s t , p r e s e n t , a n d future. We h o p e
t h a t o u r efforts toward n e w theoretical u n d e r s t a n d i n g have
sometimes benefited t h e m in t u r n .
This b o o k could n o t a n d would n o t h a v e b e e n p r o d u c e d
without t h e o u t s t a n d i n g contribution of Dr. Elizabeth Allison,
t h e Publications Editor of t h e Psychoanalysis Unit a t UCL. Her
contribution w e n t very significantly over w h a t might be expected
from s o m e o n e in t h i s role. S h e effectively conceived a n d organ-
ized t h e project, a s well a s offering s u p e r b advice on t h e integra-
tion of t h e c h a p t e r s a n d t h e dovetailing of a r g u m e n t s . We a r e
s u r e t h a t m a n y g a p s h a v e r e m a i n e d , b u t t h e level of integration
we were able to achieve is in large p a r t d u e to h e r r e m a r k a b l e
intellectual abilities a n d brilliant editorial skills. W h a t is more,
s h e w a s able to impose h e r editorial a n d intellectual discipline
on all of u s with c h a r m a n d sensitivity. Liz, we a r e all immensely
indebted to y o u .
In writing t h i s b o o k we h a v e b e e n immensely fortunate. Liz's
predecessor in t h e Publications Editor p o s t w a s Kathy Leach,

xi
xii / Acknowledgments

whose contribution w a s enormously valuable, n o t only in t h e

planning p h a s e s of t h e project, b u t also in p r e p a r i n g for publica-
tion m a n y of t h e pieces on which t h e p r e s e n t work relies. O u r
only regret is t h a t despite ingenious, tactful, a n d s o m e t i m e s
desperate efforts to k e e p t h e production of t h i s book to schedule,
we were not able to reward h e r with a complete m a n u s c r i p t .
We are also grateful to o u r publisher. Dr. Michael Moskowitz,
whose vision a b o u t a n e w kind of psychoanalytic p r e s s we s h a r e
a n d are extremely pleased to be participating in. We a r e p a r t i c u -
larly grateful for h i s patience, a s t h i s book, b o r n of work in four
countries a n d on two c o n t i n e n t s , slowly progressed to final
completion. In t e r m s of intellectual debt, m o r e people deserve
acknowledgment t h a n we could possibly list. The contribu-
tions of two people, however, h a v e b e e n clearly formative: J o h n
Watson of t h e University of California a t Berkeley h a s collabo-
rated for m a n y y e a r s with o n e of u s (GG), b u t all of u s h a v e
benefited from h i s writings a n d wisdom. Even in t h e s e d a y s of
virtual workplaces, t h i s collaboration would n o t h a v e b e e n possi-
ble without a c o m m o n workplace t h a t a t least t h r e e of t h e four of
u s s h a r e . Dr. Efrain Bleiberg's leadership of t h e Menninger
Clinic d u r i n g t h e time t h a t t h e work reported h e r e w a s u n d e r -
t a k e n h a s m a d e it possible for u s to work together in t h e Child
a n d Family Center of t h e Menninger Clinic, w h i c h Dr. Bleiberg
created a n d supervised in a truly free intellectual spirit. O t h e r s
a t t h e Child a n d Family Center, particularly Dr. J o n Allen a n d
Dr. Helen Stein, h a v e offered inspiration a n d advice. Two addi-
tional colleagues h a v e b e e n a s o u r c e of inspiration a n d guidance:
Dr. S u s a n Coates h a s followed o u r work over t h e years, a s
indeed we have followed h e r s with admiration. S h e h a s s e t a
p a t h in developmental clinical p s y c h o a n a l y s i s t h a t h a s b e e n a
t r u e inspiration. Dr. Arietta Slade h a s inspired u s n o t only in h e r
r e s e a r c h work, clinical skills, a n d scholarship, b u t t h e Integra-
tion of all t h e s e into one personality with exceptional spirit a n d
charm. We a r e grateful to h e r for h e r friendship a s well a s h e r
guidance.
Earlier b u t s o m e w h a t different formulations of some of t h e
ideas contained in this book h a v e a p p e a r e d , or will shortly
appear, in t h e following publications:
 Acknowledgments / xiii

C h a p t e r 1 incorporates s o m e material from "Attachment

a n d reflective function: Their role in self-organization" by Peter
Fonagy a n d Mary Target, w h i c h a p p e a r e d in Development and
Psychopathology, 9 (1997), 6 7 9 - 7 0 0 .
C h a p t e r 4 incorporates some material from "The social bio-
feedback model of p a r e n t a l affect-mirroring" by Gyorgy Gergely
a n d J o h n W a t s o n , w h i c h first a p p e a r e d in t h e International
Journal of Psycho-Analysis, 77(1996), 1 1 8 1 - 1 2 1 2 .
A s h o r t e r version of c h a p t e r 5, T h e development of u n d e r -
s t a n d i n g of self a n d agency" by Gyorgy Gergely, will a p p e a r in U.
G o s h w a m i (Ed.), Handbook of Childhood Cognitive Development.
Oxford: Blackwell (in press).
C h a p t e r s 6 a n d 9 incorporate material from Peter Fonagy
a n d Mary Target's "Playing with reality" series of p a p e r s ,
which a p p e a r e d in t h e International Journal of Psycho-Analysis,
77(1996), 2 1 7 - 2 3 3 ; 7 7 ( 1 9 9 6 ) , 4 5 9 - 4 7 9 ; 81 (2000), 8 5 3 - 8 7 4 .
C h a p t e r s 1 a n d 8 incorporate some material from "Attach-
m e n t a n d borderline personality disorder: A theory a n d some
evidence" by Peter Fonagy, Mary Target, a n d Gyorgy Gergely,
w h i c h first a p p e a r e d in Psychiatric Clinics of North America, 23
(2000), 1 0 3 - 1 2 2 .
T h e concluding c h a p t e r incorporates some material from
"An i n t e r p e r s o n a l view of t h e infant" by Peter Fonagy a n d Mary
Target, w h i c h first a p p e a r e d in A. H u r r y (Ed.), Psychoanalysis
and Developmental Theory {pp. 3-31). London: Karnac, 1998.
 Introduction

N u m e r o u s p a t h s come together in t h i s book. Drawing from

a wide r a n g e of sources, we ambitiously aim to a d d r e s s multi-
ple a u d i e n c e s : r e s e a r c h psychologists, clinical psychologists,
a n d p s y c h o t h e r a p i s t s , b u t also developmentalists from a c r o s s
other disciplines. From t h e m o s t general perspective, we w i s h
to highlight t h e crucial i m p o r t a n c e of developmental work to
p s y c h o t h e r a p y a n d psychopathology. We offer a n a c c o u n t of
p s y c h o t h e r a p y t h a t s e e k s to integrate o u r scientific knowledge of
psychological development with o u r experience a s clinicians,
working with children a n d a d u l t s . We believe t h a t t h e i n t e r e s t s
of o u r p a t i e n t s a r e b e s t served by a c o n s t a n t effort on t h e p a r t
both of individual t h e r a p i s t s a n d of t h e profession collectively to
bring a b o u t s u c h a n integration. T h e value of t h i s kind of inte-
gration is by n o m e a n s immediately accepted (see Green 2000;
Wolff 1996), n o r s h o u l d it be. T h e p s y c h o t h e r a p i s t offers clinical
help, mainly t h o u g h language, to people looking for help n o t
(just) from medication, b u t from s o m e o n e w h o is willing to h a v e
their m i n d s in m i n d . It c a n n o t be a s s u m e d t h a t scientific pro-
gress in adjacent disciplines will benefit p s y c h o t h e r a p e u t i c
practice. For example, we c a n well imagine t h a t progress in
Hullian or S k i n n e r i a n learning-theory r e s e a r c h in t h e 1940s a n d
1950s would h a v e b e e n of little help to p s y c h o d y n a m i c t h e r a -
pists a t t h a t time. Learning t h e o r y benefited q u i t e a different
2 / Introduction

kind of psychological therapy, less concerned with m e a n i n g a n d

t h e person t h a n with behavior a n d t h e environment.
O u r work c a n b e located within t h e well-established tradition
of interest within p s y c h o a n a l y s i s in developmental theory a n d
r e s e a r c h found a m o n g g i a n t s like A n n a Freud, Melanie Klein,
Mahler, Brody, Emde, Stern, a n d m a n y others. A particularly
inspiring example of t h e s e a m l e s s integration of developmental
a n d clinical t h o u g h t m a y b e found in a book by Anni B e r g m a n
(1999), Margaret Mahler's well-known collaborator. Many of t h e
ideas in B e r g m a n ' s b o o k will be found here, p e r h a p s c a s t in
somewhat different perspective. All developmental orientations
to p s y c h o t h e r a p y m u s t s h a r e m a n y i m p o r t a n t features a s t h e y
are all b a s e d on t h e observation of h u m a n development. At t h e
s a m e time, we believe t h a t a n u m b e r of t h e ideas d i s c u s s e d in
this book—such a s t h e social biofeedback theory of p a r e n t a l
mirroring, t h e teleological a n d Intentional s t a n c e , reflective func-
tion, t h e psychic equivalence a n d p r e t e n d m o d e s of psychic
reality, t h e alien self, mentalizing, affectivity, a n d , of course,
affect regulation a n d mentalization—suggest a genuinely n e w
direction for p s y c h o a n a l y s i s a n d psychotherapy.
From a n o t h e r perspective, however, t h i s book is n o t limited to
psychoanalytic ideas a n d c o n c e r n s . We apply a philosophy-of-
mind a p p r o a c h in order to c a p t u r e a n d specify t h e p r o c e s s by
which infants fathom t h e m i n d s of o t h e r s a n d eventually their
own m i n d s . T h e notion t h a t we fathom ourselves t h r o u g h o t h e r s
h a s its s o u r c e in G e r m a n Idealism a n d h a s b e e n articulated
further by analytic p h i l o s o p h e r s of m i n d (Jurist 2000). T h e u s e
of philosophy of m i n d in t h i s way is c o m m o n in t h e field of social
cognition. W h a t differentiates o u r a p p r o a c h is t h e a t t e n t i o n we
give not j u s t to cognition, b u t to affects a s well. In t h i s regard, we
rely on a t t a c h m e n t theory, w h i c h provides empirical s u p p o r t for
the notion t h a t a n infant's s e n s e of self emerges from t h e affec-
tive quality of relationship with t h e p r i m a r y caregiver. Indeed,
o u r work does n o t j u s t borrow from a t t a c h m e n t theory, b u t
offers a significant reformulation of it. We shall a r g u e t h a t at-
t a c h m e n t is n o t a n e n d in itself; r a t h e r , it exists in order to
produce a r e p r e s e n t a t i o n a l s y s t e m t h a t h a s evolved, we m a y
p r e s u m e , to aid h u m a n survival. A n o t h e r way to t h i n k a b o u t t h e
contribution of t h i s book, therefore, is a s a n effort to resolve
 Introduction / 3

some of t h e historical t e n s i o n s between psychoanalysis a n d

a t t a c h m e n t theory (Fonagy 2001).
Let u s s a y a little m o r e a b o u t t h e m a i n t h e m e of t h i s work
a n d its relation to t h e trio of t e r m s found in o u r title. O u r m a i n
focus t h r o u g h o u t is on -the development of r e p r e s e n t a t i o n s of
psychological s t a t e s in t h e m i n d s of infants, children, adoles-
cents, a n d a d u l t s . Mentalization—a concept t h a t is familiar in
developmental circles—is t h e p r o c e s s by w h i c h we realize t h a t
having a m i n d m e d i a t e s o u r experience of t h e world. Mentaliza-
tion is intrinsically linked to t h e development of t h e self, to its
gradually elaborated i n n e r organization, a n d to its participation
in h u m a n society, a n e t w o r k of h u m a n relationships with other
beings w h o s h a r e t h i s u n i q u e capacity. We have u s e d t h e t e r m
"reflective function" to refer to o u r operationalization of t h e
m e n t a l capacities t h a t g e n e r a t e mentalization'(Fonagy, Target,
Steele, a n d Steele 1998).
Mentalization is intimately related to t h e development of b o t h
t h e agentive a n d t h e r e p r e s e n t a t i o n a l a s p e c t s of t h e self: b o t h
t h e "I" a n d t h e "Me" described by W. J a m e s (1890). A great deal
of a t t e n t i o n h a s b e e n paid to t h e development of self-representa-
tion, J a m e s ' s "Me" or t h e "empirical self" (Lewis a n d Brooks-
G u n n 1979), w h i c h e n c o m p a s s e s t h e development of t h e set of
characteristics t h a t we believe to be t r u e of ourselves even if this
knowledge is inferred from t h e reactions to u s from o u r social
environment (Harter 1999). T h u s , this a s p e c t of mentalization is
a concept with a rich history in b o t h psychoanalytic theory
(Fonagy 1991) a n d cognitive psychology (Morton a n d Frith 1995).
However, t h e self a s a m e n t a l agent—or, a s we h a v e referred to it
elsewhere, t h e psychological self (Fonagy, Moran, a n d Target
1993; Fonagy a n d Target 1995)—is a relatively neglected subject
of study. T h e relative neglect by psychologists a n d p s y c h o a n a -
lysts of t h e developmental p r o c e s s e s t h a t u n d e r p i n t h e agentive
self m a y be s e e n a s a r e s i d u e of t h e traditionally powerful
Cartesian doctrine of first-person a u t h o r i t y t h a t claims direct
a n d infallible introspective a c c e s s to intentional m i n d s t a t e s ,
r a t h e r t h a n seeing t h i s a c c e s s a s a h a r d - w o n developmental
acquisition. T h e work of Marcia Cavell (1988, 1994, 2000),
a m o n g others, serves a s a r e m i n d e r of t h e limited extent to
which psychoanalytic metapsychology h a s b e e n able to d i s t a n c e
4 / Introduction

itself from Cartesian doctrine. Both p s y c h o a n a l y s i s a n d develop-

m e n t a l science h a v e often a d h e r e d to t h e Cartesian tradition in
their a s s u m p t i o n t h a t t h e experience of m e n t a l agency is
innately given. In t h i s book we a t t e m p t a radical b r e a k with
this d o m i n a n t philosophical tradition, a r g u i n g t h a t m e n t a l agen-
cy may be m o r e usefully s e e n a s a developing or c o n s t r u c t e d
capacity.
Developmental a n d philosophical s t u d i e s of t h e r e p r e s e n t a -
tion of intentional action h a v e revealed t h a t t h e r e p r e s e n t a t i o n of
intentional m i n d s t a t e s m a y have a r a t h e r complex i n t e r n a l
s t r u c t u r e . Conscious a c c e s s to t h e s e s t r u c t u r e s m a y b e a t b e s t
partial a n d could be totally a b s e n t . It s e e m s to u s i m p o r t a n t t h a t
we m a p t h e p r o c e s s by m e a n s of w h i c h t h e u n d e r s t a n d i n g of t h e
self a s a m e n t a l agent grows o u t of interpersonal experience,
particularly primary-object relationships. Mentalization involves
b o t h a self-reflective a n d a n interpersonal c o m p o n e n t . In combi-
nation, t h e s e provide t h e child with a capacity t o d i s t i n g u i s h
inner from outer reality, i n t r a p e r s o n a l m e n t a l a n d emotional
processes from interpersonal c o m m u n i c a t i o n s . In t h i s book we
p r e s e n t b o t h clinical a n d empirical evidence in conjunction with
developmental observation to d e m o n s t r a t e t h a t t h e b a b y ' s expe-
rience of himself a s a n o r g a n i s m with a m i n d or psychological
self is n o t a genetic given. 1 It is a s t r u c t u r e t h a t evolves from
infancy t h r o u g h childhood, a n d its development critically de-
p e n d s u p o n interaction with m o r e m a t u r e m i n d s , w h o a r e b o t h
benign a n d reflective in their t u r n .
O u r u n d e r s t a n d i n g of mentalization is n o t j u s t a s a cognitive
process, b u t developmentally c o m m e n c e s with t h e "discovery" of
affects t h r o u g h t h e primary-object relationships. For t h i s rea-
son, we focus on t h e concept of "affect regulation," w h i c h is
i m p o r t a n t in m a n y s p h e r e s of developmental theory a n d theories
of psychopathology (e.g., Clarkin a n d Lenzenweger 1996). Affect
regulation, the capacity to m o d u l a t e affect s t a t e s , is closely
related to mentalization in t h a t it plays a f u n d a m e n t a l role in t h e
unfolding of a s e n s e of self a n d agency. In o u r a c c o u n t , affect

1
For economy and clarity, we refer to the child as "he" and to either the
parent or the therapist as "she." This is not meant to suggest any difference
between male and female babies or male and female parents or therapists.
 Introduction / 5

regulation-is a p r e l u d e to mentalization; yet, we also believe t h a t

once mentalization h a s occurred, t h e n a t u r e of affect regulation
is transformed. Here we distinguish between affect regulation a s
a kind of a d j u s t m e n t of affect s t a t e s a n d a more sophisticated
variation, w h e r e affects a r e u s e d to regulate the self. T h e concept
of "mentalized affectivity" m a r k s a m a t u r e capacity for t h e regu-
lation of affect a n d d e n o t e s t h e capacity to discover t h e subjec-
tive m e a n i n g s of one's own affect states. Mentalized affectivity
lies, we suggest, a t t h e core of t h e p s y c h o t h e r a p e u t i c enterprise.
It r e p r e s e n t s t h e experiential u n d e r s t a n d i n g of one's feelings in a
way t h a t e x t e n d s beyond intellectual u n d e r s t a n d i n g . It is in t h i s
realm t h a t we e n c o u n t e r r e s i s t a n c e s a n d defenses, n o t j u s t
against specific emotional experiences, b u t a g a i n s t entire m o d e s
of psychological functioning; n o t j u s t distortions of m e n t a l repre-
s e n t a t i o n s s t a n d i n g in t h e w a y of t h e r a p e u t i c progress, b u t also
inhibitions of m e n t a l functioning (Fonagy, E d g c u m b e , Moran,
Kennedy, a n d Target 1993). T h u s we c a n m i s u n d e r s t a n d w h a t
we feel, t h i n k i n g t h a t we feel one t h i n g while truly feeling a n -
other emotion. Moreover, it is even possible t h a t we c a n deprive
ourselves of t h e entire experiential world of emotional richness.
For example, t h e inability to envision psychological a n d psycho-
social c a u s a t i o n m a y b e t h e c o n s e q u e n c e of t h e pervasive inhibi-
tion a n d / o r developmental malformation of t h e psychological
p r o c e s s e s t h a t u n d e r p i n t h e s e capacities.
O u r theory of affect regulation a n d mentalization enables u s
to enrich t h e a r g u m e n t s a d v a n c e d by t h e o r i s t s s u c h a s J o h n
Bowlby a b o u t t h e evolutionary function of a t t a c h m e n t . We a r g u e
t h a t a n evolutionary function, of early object relations is to equip
the very y o u n g child with a n e n v i r o n m e n t within which t h e
u n d e r s t a n d i n g of m e n t a l s t a t e s in o t h e r s a n d t h e self c a n fully
develop. We p r o p o s e t h a t self-reflection a s well a s t h e ability to
reflect on o t h e r m i n d s a r e c o n s t r u c t e d capacities t h a t h a v e
evolved (or not) o u t of t h e earliest-relationships. Since mentaliza-
tion is a core a s p e c t of h u m a n social functioning, we c a n infer
t h a t evolution h a s placed p a r t i c u l a r value on developing m e n t a l
s t r u c t u r e s for interpreting i n t e r p e r s o n a l actions. Language is, of
course, t h e major c h a n n e l for symbolic interaction. Yet, in order
for language to function adequately, t h e subjective world re-
quires organization. Internal s t a t e s m u s t have a m e a n i n g in
 6 / Introduction

order to be c o m m u n i c a t e d to o t h e r s a n d interpreted in o t h e r s to
guide collaboration in work, love, a n d play.
It should be readily a p p a r e n t t h a t t h i s book places consider-
able e m p h a s i s on early social experience a s a p r i m a r y m o d e r a t o r
of t h e m e n t a l capacities centrally involved in psychological disor-
ders a n d their p s y c h o t h e r a p e u t i c t r e a t m e n t . In t h i s respect t h e
work is a c o n t i n u a t i o n of a psychosocial tradition t h a t h a s s e e n
parenting practices a n d t h e early social e n v i r o n m e n t a s t h e key
to developmental psychopathology (Cicchetti a n d Cohen 1995; A.
Freud 1981; M a s t e n a n d Braswell 1991; R u t t e r 1993; Sameroff
1995; Sroufe 1996). We recognize t h a t t h i s perspective, while
u n d o u b t e d l y d o m i n a n t in psychiatry a n d social science d u r i n g
m o s t of t h e p a s t century, h a s come u n d e r increasing critical
scrutiny in t h e light of more recent evidence from behavior-
genetic adoption a n d twin s t u d i e s (Eaves et al. 1997; Hewitt et
al. 1997). It is very probably t r u e t h a t p a s t s t u d i e s m i g h t have
overestimated t h e influence of t h e social e n v i r o n m e n t on devel-
o p m e n t b e c a u s e t h e y failed to control for genetic influences. We
note, however, t h a t c u r r e n t psychiatric literature is showing
signs of a r e t u r n of a naively nativist perspective, w h e r e genetic
d a t a a r e viewed a s indicating t h a t a psychological level of analy-
sis c a n n o t be productive. Consequently, early e n v i r o n m e n t is
given little significance, a n d s u c h significance a s is accorded to it
is from a physical r a t h e r t h a n a psychological perspective (e.g.,
Marenco a n d Weinberger 2000).
While it is clear t h a t psychological principles c a n n o t violate
the limitations set by t h e neurophysiological capabilities of t h e
s y s t e m s t h a t s u b s e r v e t h e m , .this does n o t imply t h e r e d u c t i o n of
psychology to biology. In t h i s b o o k we t a k e i s s u e with t h e "genet-
icization" of h u m a n behavior. We a d o p t a position in line with
t h a t of t h e evolutionists D o b z h a n s k y (1972) a n d Gould (1987).
We consider t h a t n a t u r e (genetics o r genes) o p e r a t e s a s a "poten-
tialist" r a t h e r t h a n a s a "determinist." Since biological determin-
ism is frequently clothed in t h e l a n g u a g e of malleability a n d
interactionism, we note t h a t in reality, b e h i n d t h e s e m o r e palat-
able portrayals of biology, genes a r e still considered t h e primary-
ruling force. While changeability of evolved dispositions is ac-
knowledged, t h e s e inherited t r a i t s a r e t h e n s e e n a s predomi-
 Introduction / 7

n a n t . We suggest t h a t t h i s t e n d e n c y c a n occur b e c a u s e of t h e
a b s e n c e of convincing d a t a on g e n e - e n v i r o n m e n t interaction. Yet
m o d e r n genetics h a s provided ample room for t h e contention
t h a t biology h a s c u l t u r e on a "loose" r a t h e r t h a n a "tight leash"
(Gould 1987).
We a t t r i b u t e t h e failure of behavior geneticists to find
convincing evidence for g e n e - e n v i r o n m e n t interaction to their
predisposition to s t u d y the "wrong" environment: t h e physical
r a t h e r t h a n t h e psychological. We suggest t h a t t h e decline of
interest in subjectivity, in t h e m e c h a n i s m t h a t interprets t h e
social world, is partly to b l a m e for t h i s g a p in o u r knowledge. We
a r g u e t h a t it is t h e m a n n e r in w h i c h t h e e n v i r o n m e n t is experi-
enced t h a t a c t s a s a filter in t h e expression of genotype into
phenotype. T h e i n t r a p s y c h i c r e p r e s e n t a t i o n a l p r o c e s s e s t h a t u n -
derpin t h e agentive self are n o t j u s t t h e c o n s e q u e n c e s of b o t h
environmental a n d genetic effects. They m a y acquire additional
i m p o r t a n c e a s moderators of t h e effects of t h e environment u p o n
t h e unfolding of genotype into p h e n o t y p e . We place mentaliza-
tion a t t h e h e a r t of t h i s p r o c e s s of moderation, since it is t h e
interpretation o f t h e social e n v i r o n m e n t r a t h e r t h a n t h e physical
environment t h a t governs genetic expression.
T h e s e c o n s i d e r a t i o n s h a v e led u s to reformulate o u r u n d e r -
s t a n d i n g of t h e i m p a c t of early social relationships on later
experience. We move away from t h e model w h e r e a n early rela-
tionship is principally s e e n a s t h e g e n e r a t o r of a t e m p l a t e for
later r e l a t i o n s h i p s (e.g., Bowlby 1980). Instead, we a r g u e t h a t
early experience, n o d o u b t via its i m p a c t on development a t
b o t h psychological a n d neurophysiological levels, d e t e r m i n e s t h e
"depth" to w h i c h t h e social e n v i r o n m e n t m a y be processed.
S u b o p t i m a l early experiences of c a r e affect later development by
u n d e r m i n i n g t h e individual's capacity to process or i n t e r p r e t
information c o n c e r n i n g m e n t a l s t a t e s t h a t is essential for effec-
tive functioning in a stressful social world. Insecurity in a t t a c h -
m e n t r e l a t i o n s h i p s is a signal of limitation in mentalizing skills.
We find t h a t t h e traditional classification of a t t a c h m e n t p a t t e r n s
m a y be helpfully reinterpreted in t h i s context a s indication of a
relatively good (secure a t t a c h m e n t ) , or relatively poor (insecure
a t t a c h m e n t ) capacity to m a n a g e or cope with i n t i m a t e Inter-
8 / Introduction

p e r s o n a l relationships. An a b s e n c e of mentalizing capacity u n -

der s t r e s s is signaled by t h e disorganization of t h e a t t a c h m e n t
system.
So w h a t aspect of t h e e n v i r o n m e n t c a n b e specified a s critical
to t h e healthy development of a n agentive or psychological self?
Attuned interactions with t h e p a r e n t (Jaffe, Beebe, Feldstein,
Crown, a n d J a s n o w 2001; S t e r n 1985) often involve affect-mir-
roring—that is, t h e p a r e n t ' s u s e of facial a n d vocal expression to
represent to t h e child t h e feelings s h e a s s u m e s h i m to h a v e in
s u c h a way a s to r e a s s u r e a n d calm r a t h e r t h a n intensify h i s
emotions. We see p a r e n t a l affect-mirroring a s i n s t r u m e n t a l in
fostering t h e capacity for affect regulation, t h r o u g h t h e creation
of a second-order r e p r e s e n t a t i o n for constitutional affect s t a t e s .
The image of t h e caregiver mirroring t h e i n t e r n a l experience of
t h e infant comes to organize t h e child's emotional experience.
T h u s t h e self is n o t merely open to environmental influence: it is
in p a r t constituted t h r o u g h its interactions with t h e social envi-
r o n m e n t . Freud, arguably, s a w infancy a s a time w h e n t h e self
s a w o t h e r s a s extensions of itself (e.g., F r e u d 1900a). O u r em-
p h a s i s is t h e reverse—we see t h e self a s originally a n extension
of experience of t h e other.
We propose two intimately connected developmental theories.
Both concern t h e relationship between t h e acquisition of a n
u n d e r s t a n d i n g of t h e r e p r e s e n t a t i o n a l n a t u r e of m i n d s on t h e
one h a n d a n d affect regulation on t h e other. The social biofeed-
b a c k theory of p a r e n t a l affect-mirroring explores t h e way in
which t h e infant's a u t o m a t i c emotion expression a n d t h e care-
giver's c o n s e q u e n t affect-reflective facial a n d vocal displays come
to be linked in t h e infant's m i n d t h r o u g h a contingency-detection
m e c h a n i s m Identified by J o h n W a t s o n a n d colleagues (Bahrick
a n d W a t s o n 1985; Gergely a n d W a t s o n 1996; W a t s o n 1972,
1994). (This m e c h a n i s m is described quite fully in c h a p t e r 4.)
The forging of this link h a s two i m p o r t a n t effects: (a) The infants
come to associate t h e control t h e y h a v e over their p a r e n t s '
mirroring displays with t h e resulting improvement, in their emo-
tional state, leading, eventually, to a n experience of t h e self a s a
regulating agent, (b) T h e e s t a b l i s h m e n t of a second-order repre-
sentation of affect s t a t e s c r e a t e s - t h e b a s i s for affect regulation
a n d impulse control. Affects c a n be m a n i p u l a t e d a n d discharged
 Introduction / 9

internally a s well a s t h r o u g h action; t h e y c a n also b e experienced

a s s o m e t h i n g recognizable a n d h e n c e s h a r e d . Affect expressions
by t h e p a r e n t t h a t a r e n o t contingent on t h e infant's affect will
u n d e r m i n e t h e a p p r o p r i a t e labeling of internal states, w h i c h
may, in t u r n , r e m a i n confusing, experienced a s unsymbolized,
a n d h a r d to regulate.
For affect-mirroring to serve a s t h e b a s i s o f t h e development
of a r e p r e s e n t a t i o n a l framework, t h e caregiver m u s t s o m e h o w
indicate t h a t h e r display is n o t for real: it is n o t a n indication of
how t h e p a r e n t herself feels. We describe this characteristic of
t h e p a r e n t ' s mirroring behavior a s its "markedness." A display
t h a t is c o n g r u e n t with t h e b a b y ' s s t a t e b u t lacks m a r k e d n e s s
m a y overwhelm t h e infant. It is felt to b e t h e p a r e n t ' s own real
emotion, m a k i n g t h e infant's experience seem contagious, or
universal, a n d t h u s m o r e d a n g e r o u s . In t h e s h o r t term, t h e
infant's perception of a corresponding b u t realistic negative emo-
tion is likely to escalate r a t h e r t h a n regulate t h e infant's state,
leading to t r a u m a t i z a t i o n r a t h e r t h a n c o n t a i n m e n t .
O u r second theory c o n c e r n s t h e n a t u r e of subjectivity before
recognition o f t h e r e p r e s e n t a t i o n a l c h a r a c t e r o f t h e h u m a n mind.
We suggest t h a t t h e infant's a n d y o u n g child's early a w a r e n e s s of
m e n t a l s t a t e s is characterized by t h e e q u a t i o n of t h e internal
with t h e external. W h a t exists in the m i n d m u s t exist o u t there,
a n d w h a t exists o u t t h e r e m u s t invariably also exist in t h e mind.
Psychic equivalence, a s a mode of experiencing t h e internal
world, c a n c a u s e i n t e n s e distress, since t h e projection of fantasy
to t h e outside world c a n b e terrifying. T h e acquisition of a s e n s e
of pretend in relation to-mental s t a t e s is therefore essential. T h e
repeated experience of affect-regulative mirroring helps t h e child
to learn t h a t feelings do n o t inevitably spill o u t into t h e world.
The child's m e n t a l s t a t e is decoupled from physical reality. We
suggest t h a t children w h o s e p a r e n t s provide more affect-congru-
e n t contingent, a n d appropriately m a r k e d , mirroring displays
facilitate t h i s decoupling. In c o n t r a s t , t h e displays of p a r e n t s
who, b e c a u s e of their own difficulties with emotion regulation,
are readily overwhelmed by t h e infant's negative affect a n d pro-
d u c e a realistic u n m a r k e d emotion expression d i s r u p t t h e devel-
o p m e n t of affect regulation. A major opportunity for learning
a b o u t t h e difference between r e p r e s e n t a t i o n a l a n d a c t u a l m e n t a l
10 / Introduction

s t a t e s is lost. We a r g u e t h a t t h e e q u a t i o n of external a n d i n t e r n a l
c o n t i n u e s to d o m i n a t e t h e subjective world of individuals with
severe personality disorders.
Affect-mirroring c a n t a k e pathological p a t h w a y s , b e c a u s e t h e
caregiver is overwhelmed by t h e negative affect generated in
r e s p o n s e to t h e infant's reaction a n d p r e s e n t s a n overly realistic
emotionally a r o u s i n g display. This u n d e r m i n e s n o t only t h e in-
fant's possibility of creating a s e c o n d a r y representation, b u t also
t h e s e n s e of a. b o u n d a r y between self a n d o t h e r — a n i n t e r n a l
experience s u d d e n l y b e c o m e s external t h r o u g h t h e experience
equivalent to contagion. We believe t h a t t h i s c o r r e s p o n d s to t h e
clinical characterizations of projective identification, t h e h a b i t -
ual defense particularly associated with borderline personality
disorder (BPD). S u s t a i n e d experience of t h i s kind might, we
argue, play a n i m p o r t a n t role in establishing projective identifi-
cation a s t h e d o m i n a n t form of emotional experience in t h e
development of borderline personality. It should be noted t h a t we
u s e t h e t e r m "borderline" in t h i s book in t h e s e n s e of a form of
pathological personality organization t h a t could b e a likely factor
in all serious personality disorder, r a t h e r t h a n j u s t t h e m o r e
specific DSM-IV category of personality disorder. Borderline Per-
sonality Disorder. T h e model a d v a n c e d in t h i s book is i n t e n d e d
to explain borderline p h e n o m e n a in m a n y patients, n o t j u s t
t h o s e who meet formal diagnostic criteria. O u r a i m is to c a s t
light on t h e n a t u r e of t h e m e n t a l functioning of a larger g r o u p of
p a t i e n t s — p e r h a p s t h o s e w h o fit Otto Kernberg's (1967) classical
description of borderline personality organization—whose t h i n k -
ing a n d emotional experience often b e c o m e s massively disorgan-
ized a n d regressed in t h e clinical setting, evoking i n t e n s e
feelings in t h e t h e r a p i s t (e.g., Rey 1979). T h e emotional lability
t h a t is a h a l l m a r k of t h e s e patients.is generally regarded to be a
clue to t h e n a t u r e of their d i s t u r b a n c e . Their t h e r a p y rarely
takes place w i t h o u t d r a m a t i c e n a c t m e n t s — t h e i r own a n d some-
times their t h e r a p i s t s ' — a n d their i n t e n s e d e p e n d e n c e on t h e
therapist increases t h e difficulties o f t h e t r e a t m e n t process.
A second type of deviant mirroring s t r u c t u r e is o n e t h a t we
feel predisposes to narcissistic personality disorder r a t h e r
t h a n to borderline states. W h e n affect-mirroring is appropriately
 Introduction / 11

m a r k e d b u t is n o n c o n t i n g e n t , in t h a t t h e infant's emotion is
misperceived by t h e caregiver, t h e b a b y will still feel t h e mirrored
affect display to m a p onto h i s p r i m a r y emotion state. However,
a s t h i s mirrored s t a t e is i n c o n g r u e n t with t h e infant's a c t u a l
feelings, t h e s e c o n d a r y r e p r e s e n t a t i o n created will b e distorted.
T h e infant will mislabel t h e primary, constitutional emotional
state. T h e self-representation will n o t have strong ties to t h e
underlying emotional state. T h e individual m a y convey a n im-
p r e s s i o n of reality, b u t a s t h e constitutional s t a t e h a s n o t b e e n
recognized by t h e caregiver, t h e self will feel empty b e c a u s e it
reflects t h e activation of s e c o n d a r y r e p r e s e n t a t i o n s of affect t h a t
lack t h e c o r r e s p o n d i n g c o n n e c t i o n s within t h e constitutional
self. 2 Only w h e n p s y c h o t h e r a p y g e n e r a t e s mentalized affectivity
will t h i s fault line in t h e psychological self be bridged.
We h a v e a t t e m p t e d to specify In greater detail t h e psychologi-
cal m e c h a n i s m t h a t u n d e r p i n s t h e p r o c e s s e s by which p a r e n t a l
affect-mirroring deviates from its n o r m a l c o u r s e in t e r m s of o u r
concept of t h e alien self. In general we m i g h t say t h a t t h e self a s
agent a r i s e s o u t of t h e infant's perception of h i s p r e s u m e d
intentionality in t h e m i n d of t h e caregiver. Where p a r e n t a l care-
giving is extremely insensitive a n d m i s a t t u n e d , we a s s u m e t h a t
a fault is created in t h e construction of t h e psychological self. We
follow Winnicott's (1967) suggestion t h a t t h e infant, failing to
find himself in t h e m o t h e r ' s m i n d , finds t h e m o t h e r instead. T h e
infant is forced to internalize t h e r e p r e s e n t a t i o n of t h e object's
state of m i n d a s a core p a r t of himself. B u t in s u c h c a s e s
t h e internalized o t h e r r e m a i n s alien a n d u n c o n n e c t e d to t h e
s t r u c t u r e s of t h e constitutional self. In t h e case of chronically
insensitive or m i s a t t u n e d caregiving, a fault is created in t h e
construction of t h e self, whereby t h e infant is forced to internal-
ize t h e r e p r e s e n t a t i o n o f t h e object's s t a t e of m i n d a s a core p a r t
of himself.
In early development t h i s "alien s e l f is dealt with by ex-
ternalization; a s mentalization develops, it c a n be increasingly

2
By "constitutional self we mean an individual's biologically determined
experiences associated with emotional expressivity as well as temperamental
manifestations of affect.
12 / Introduction

woven into t h e self, creating a n illusion of cohesion. T h u s , t h e

y o u n g child showing disorganized a t t a c h m e n t will frequently
control a n d m a n i p u l a t e t h e p a r e n t ' s behavior. This is p a r t of a
projective identificatory.process whereby h e achieves h i s need to
experience his self a s coherent, a n d t h e alien .part of h i s self-
s t r u c t u r e a s outside h i s m i n d , by perceiving t h e s e elements
within other selves, normally within a p a r e n t . T h e disorganiza-
tion of t h e self disorganizes a t t a c h m e n t r e l a t i o n s h i p s b y creating
a c o n s t a n t need for t h i s projective identification—the externali-
zation o f t h e alien self—in a n y a t t a c h m e n t relationship.
The alien self is p r e s e n t in all of u s , b e c a u s e t r a n s i e n t neglect
is p a r t of ordinary caregiving; with t h e development of mentaliza-
tion, a n d given a mid-childhood e n v i r o n m e n t relatively free of
t r a u m a , t h e g a p s in t h e self corresponding to n o n c o n t i n g e n t
p a r e n t i n g are covered over by t h e self-narratives t h a t t h e r e a s o n -
ably functioning rnind c a n create. The alien self is mostly perni-
cious w h e n later experiences of t r a u m a in t h e family or t h e peer
g r o u p force t h e child to dissociate from p a i n by u s i n g t h e alien
self to identify with t h e aggressor. In t h e s e c a s e s t h e g a p s come
to be colonized by t h e image of t h e aggressor, a n d t h e child
comes to experience himself a s destructive a n d , in t h e extreme,
m o n s t r o u s . T h u s we see i n a d e q u a t e early p a r e n t i n g a s creating a
vulnerability t h a t m a y become destructive of development a n d
seriously pathogenic if later experience is unfavorable, either
in t e r m s of failing to facilitate t h e later development of mentali-
zation or explicitly calling for t h e u s e of t h e faults in self-
development for defensive p u r p o s e s . T h e s e factors interact, a n d
the likelihood of surviving psychological a s s a u l t improves if
mentalizing is freely available to interpret t h e p e r p e t r a t o r ' s
behavior (Fonagy, Steele, Steele, Higgitt, a n d Target 1994). How-
ever, brutalization in t h e context of a t t a c h m e n t relationships
generates i n t e n s e s h a m e . This, if coupled with a history of
neglect a n d a c o n s e q u e n t w e a k n e s s in mentalization, b e c o m e s a
likely trigger for violence against t h e self or others, b e c a u s e o f t h e
intensity of t h e humiliation experienced w h e n t h e t r a u m a c a n n o t
be processed a n d a t t e n u a t e d via mentalization. Unmentalized
s h a m e , which r e m a i n s u n m e d i a t e d by a n y s e n s e of d i s t a n c e
between feelings a n d objective realities, is t h e n experienced a s
 Introduction / 13

t h e d e s t r u c t i o n of t h e self. We have called it "ego-destructive

s h a m e . " T h e u s e of t h e alien, dissociated p a r t of t h e self to
c o n t a i n t h e image of t h e aggressor a n d t h e u n t h i n k a b l e affect
generated by their a b u s i v e a c t i o n s is a survival strategy for m a n y
individuals, s o m e of w h o m we try to describe in this book.
T h e defensive u s e of t h e alien p a r t of t h e self is deeply
pathogenic, a l t h o u g h initially adaptive. In o u r view it m a r k s t h e
development of s e r i o u s personality problems. It involves t h r e e
i m p o r t a n t c h a n g e s : (a) a further r e p u d i a t i o n of mentalization, a t
least in a t t a c h m e n t contexts, (b) d i s r u p t i o n of t h e psychological
self by t h e emergence of a t o r t u r i n g other within t h e self, a n d
(c) vital d e p e n d e n c e on t h e physical p r e s e n c e of t h e other a s a
vehicle for externalization. T h e s e features, in combination, ac-
c o u n t for m a n y a s p e c t s of disordered functioning in borderline
p a t i e n t s . A b u s e d a n d t r a u m a t i z e d individuals, u n a b l e to con-
ceive of t h e m e n t a l s t a t e s t h a t could explain t h e actions of t h e
a b u s e r , voluntarily a n d defensively sacrifice their thinking a b o u t
i n t e r n a l s t a t e s . While able to t h i n k of m e n t a l s t a t e s in self
a n d o t h e r in t h e context of ordinary social relationships, t h e y
inevitably b e c o m e conflicted a n d entangled once a relationship
b e c o m e s emotionally intense, organized by m e n t a l s t r u c t u r e s
t h a t a r e involved in a t t a c h m e n t relationships. T h e a b a n d o n m e n t
of mentalizing leaves t h e m with a n i n t e r n a l reality t h a t is domi-
n a t e d by psychic equivalence. T h e s e individuals, like all other
patients, organize t h e t h e r a p e u t i c relationship to conform to
their u n c o n s c i o u s expectations, except t h a t for t h e m t h e s e ex-
pectations h a v e t h e full force of reality a n d t h e r e is n o s e n s e of
alternative perspectives. T h e inability to t h i n k a b o u t m e n t a l
s t a t e s removes t h e possibility of "narrative smoothing" of t h e
basic g a p s in t h e self-structure, a n d t h e alien self emerges in a
m a n n e r m u c h clearer for t h e t h e r a p i s t to see a n d experience.
Splitting b e c o m e s a d o m i n a n t defense a n d projective identifica-
tion—the externalization of t h e alien self—an essential p a r t of
survival. T h e vehicles for t h e projective identification m u s t be
p r e s e n t for t h e p r o c e s s of externalization to function, a n d total
d e p e n d e n c y on t h e s e individuals t u r n s into a d o m i n a n t t h e m e .
O u r reformulation of t h e significance of t h e early social en-
vironment h a s i m p o r t a n t clinical implications. Psychotherapy
14 / Introduction

with individuals whose early experiences h a v e led to a compro-

mised mentalizing capacity should b e focused on helping t h e m
to build this interpersonal interpretive capacity. O n e way of
conceptualizing t h e entire p s y c h o t h e r a p e u t i c enterprise m a y . b e
a s a n activity t h a t is specifically focused on t h e rehabilitation of
this function. The w o r k of m a n y previous theoreticians c a n b e
reread in t h e light of o u r reformulation. T h r o u g h o u t t h e b o o k we
often point o u t t h a t t h e ideas being advanced h e r e were antici-
pated in t h e work of great psychoanalytic theoreticians, n o t least
those in t h e object-relations tradition. For example, we m a k e
m a n y connections with Bion's (1959) t h i n k i n g a b o u t contain-
ment. The interpersonal interpretive s t a n c e of t h e h u m a n b r a i n
is a n overarching biological c o n s t r u c t (Bogdan 2001): Its limits
are a s yet unexplored. O u r c o n c e r n s in t h i s book a r e principally
with reflective function a n d mentalization—capacities t h a t a r e
likely to t u r n o u t to be specific i n s t a n c e s of t h i s m o r e general
capacity.
An i m p o r t a n t aim of p s y c h o t h e r a p y , t h e n , if n o t its central
aim, is t h e extension of mentalization. With s o m e p a t i e n t s , p a r -
ticularly t h o s e a t t h e borderline e n d of t h e s p e c t r u m , t h e t h e r a -
pist's t a s k m a y be considered to be similar to t h a t of t h e p a r e n t
who intuitively engages with t h e child's world of psychic equiva-
lence to e m p h a s i z e its r e p r e s e n t a t i o n a l c h a r a c t e r . Integrating
the concrete a n d dissociated (pretend) m o d e s of functioning c a n
only be a c h i e v e d . t h r o u g h focused work on t h e p a t i e n t ' s c u r r e n t
experience of t h e transference. S o m e e n a c t m e n t s on t h e p a r t of
b o t h t h e r a p i s t a n d patient are a n inevitable p a r t of t h i s work,
since t h e p a t i e n t c a n n o t r e m a i n psychologically close to t h e
therapist w i t h o u t externalizing t h e alien p a r t s of t h e self. It is a t
these m o m e n t s , w h e n t h e t h e r a p i s t is enacting t h e split-off p a r t
of the patient's experience, t h a t t h e p a t i e n t ' s t r u e self m a y b e
most accurately observed. Sadly, a l m o s t invariably t h e t h e r a p i s t
will have extreme difficulty in c o m m u n i c a t i n g insight a n d u n d e r r
standing at s u c h times. It is far m o r e likely, in t h e middle of s u c h
turmoil, t h a t t h e t h e r a p i s t ' s rage or terror or b o t h will o b s c u r e
h e r vision of t h e patient. Nevertheless, p e r s i s t e n c e a n d a deter-
mined focus on u n d e r s t a n d i n g t h e m o m e n t - t o ^ m o m e n t c h a n g e s
in t h e patient's experience u s u a l l y p a y s off, a n d t h e p s y c h o t h e r a -
peutic t r e a t m e n t of even quite severely impaired p a t i e n t s c a n be
 Introduction / 15

surprisingly effective ( B a t e m a n a n d Fonagy 1999) a n d lasting

(Bateman a n d Fonagy 2001).
Not all borderline p a t i e n t s a r e a s severely d i s t u r b e d a s t h e
above description implies, a l t h o u g h m o s t have features con-
t a i n e d in it. If t h e caregiver h a s p r e s e n t e d affect displays to
t h e infant t h a t correspond poorly to t h e child's constitutional
self-state, affect regulation will b e b a s e d on second-order repre-
s e n t a t i o n s of affects t h a t do n o t have s t r o n g c o n n e c t i o n s with
constitutional self-states. I n a c c u r a t e mirroring by t h e caregiver
will lead to emotional experiences t h a t c a n n o t be experienced a s
"true." Consequently, t h e s e c o n d a r y representational s t r u c t u r e s
will not.provide a m e a n s for accessing a n d attributing emotion
s t a t e s to t h e self. So w o r d s will n o t form t h e b a s i s for t h e child's
emerging ability to t h i n k aboui: h i s or h e r real t h o u g h t s a n d
wishes. T h e a i m of p s y c h o t h e r a p y for t h e s e individuals is to
r e g e n e r a t e t h e connection between t h e c o n s c i o u s n e s s of a n af-
fect s t a t e a n d Its experience a t t h e constitutional level. We have
labeled t h i s "mentalized affectivity"—a t e r m intended to indicate
t h e capacity to c o n n e c t to t h e m e a n i n g of one's emotions. The
clinical e m p h a s i s on experiential u n d e r s t a n d i n g of one's feelings
in a way t h a t e n s u r e s "meaningfulness" is crucial b e c a u s e it
serves to establish c o n g r u e n t c o n n e c t i o n s between primary a n d
s e c o n d a r y affect-representational s t r u c t u r e s . The focus on
emotion e n s u r e s t h a t t h e s e c o n d a r y r e p r e s e n t a t i o n a l s t r u c t u r e s
u s e d to t h i n k a b o u t or to reflect o n affect a r e reconnected a n d
t h a t m i s c o n n e c t i o n s w h e r e displayed affect w a s tied to a differ-
e n t n o n c o n s c i o u s affect s t a t e a r e corrected.
This b o o k is divided into t h r e e p a r t s . T h e first p a r t (chapters
1-3) is theoretical; t h e second p a r t (chapters 4-8) is developmen-
tal; t h e third p a r t (chapters 9-11) is clinical. T h e book concludes
with a n Epilogue. T h e tripartite division is primarily a m a t t e r of
convenience; it is n o t m e a n t to convey t h a t t h e c o m p o n e n t s of
t h e c o n t e n t a r e s e p a r a t e . T h e r e a d e r will find, for example, t h a t
in t h e theoretical p a r t t h e r e is considerable d i s c u s s i o n of devel-
opmental material; t h a t in t h e developmental p a r t t h e r e is impor-
t a n t theoretical m a t e r i a l on. t h e self a s well a s t h e introduction of
some clinical material. This is deliberate. T h r o u g h o u t t h i s work,
we a t t e m p t to integrate theory, development, a n d t h e clinical
sphere. We a r e committed to forging a theory t h a t is inspired by
16 / Introduction

clinical observation a n d rooted in t h e findings of s y s t e m a t i c

research. O u r aim is to bring b o t h theory a n d r e s e a r c h to b e a r on
clinical practice.
The content of t h e c h a p t e r s is a s follows: C h a p t e r 1 offers a n
overview of t h e major t h e m e s to be covered in t h e book. We
survey t h e links between a t t a c h m e n t theory, s t u d i e s of early
social development, a n d s t u d i e s of. cognitive development t h a t
focus on one a p p r o a c h to mentalization—the s t u d y o f t h e acqui-
sition of a "theory of mind." We s k e t c h a n outline (to be filled in
later) of w h a t we k n o w a b o u t t h e developmental c o u r s e of self-
organization a n d t h e developmental deviations t h a t c a n r e s u l t
from a n adverse early environment, later t r a u m a , or b o t h . We
introduce t h e notion of mentalization a s a potential mediator of
psychosocial risk.
In c h a p t e r 2, we consider b r o a d intellectual t r e n d s in theories
of affect, a c r o s s a r a n g e of disciplines. We suggest t h a t t h e
dialectic between t h o s e who see affect a s inevitably disorganizing
a n d external to cognitive influence a n d t h o s e w h o a t t e m p t to
integrate affect a s a form of cognitive activity m a y be a d d r e s s e d
t h r o u g h t h e concept of mentalization a n d — m o r e narrowly—
mentalized affectivity. We i n t r o d u c e a distinction between first-
a n d second-order r e p r e s e n t a t i o n of affect a n d a r g u e t h a t t h i s
distinction is c o n s i s t e n t with d a t a from psychology, n e u r o p h y s i -
ology, a n d psychoanalytic theories.
In c h a p t e r 3, we a d d r e s s t h e challenge posed by r e c e n t a r g u -
m e n t s a b o u t t h e relative i m p o r t a n c e of g e n e s a n d t h e early
environment to a mainly psychosocial model of personality de-
velopment. It m a y s e e m foolhardy to a d v a n c e a model in w h i c h
the capacity for mentalization is rooted in a n a t t a c h m e n t rela-
tionship, a t a time w h e n social cognitive capacities a r e increas-
ingly s e e n a s being genetically determined r a t h e r t h a n a s
p r o d u c t s of t h e early environment. We c o u n t e r t h i s challenge by
arguing t h a t t h e h u m a n capacity for interpreting t h e social
environment is a key m o d e r a t i n g influence in t h e expression of
genes in p h e n o t y p e s . Mentalization a n d the, family-of capacities
to which it belongs (deriving from t h e "interpersonal interpretive
mechanism") c a n be either facilitated or r e t a r d e d by a t t a c h m e n t
experiences a n d c a n play a key role in creating a n experienced
environment. As p a r t of t h i s a r g u m e n t , we p r o p o s e a reorienta-
 Introduction / 17

tion of a t t a c h m e n t theory, from a n e m p h a s i s on t e m p l a t e s for

relationships, fixed in early infancy, to a model t h a t views at-
t a c h m e n t a s t h e context provided by evolution for t h e develop-
m e n t of i n t e r p e r s o n a l u n d e r s t a n d i n g .
C h a p t e r 4 p r e s e n t s in detail o u r developmental model of how
a n i n t e r p e r s o n a l interpretive m e c h a n i s m for affect might evolve
intersubjectively, in t h e context o f t h e infant-caregiver relation-
ship. T h i s is a p a r s i m o n i o u s model. Traditionally, p s y c h o a n a -
lytic developmental models h a v e m a d e extravagant a s s u m p t i o n s
a b o u t infants' capacities. This w a s one of t h e major foci of
the Controversial D i s c u s s i o n s between A n n a F r e u d a n d Melanie
Klein (King a n d Steiner 1991). In contrast, o u r m o r e parsimoni-
o u s model is b a s e d on Gergely a n d W a t s o n ' s (1996) Social Bio-
feedback Theory, w h i c h is, in t u r n , rooted in W a t s o n ' s work on
t h e developmental functions of t h e h u m a n infant's sensitivity to
contingent r e l a t i o n s h i p s between h i s proprioception (of inten-
tional movement) a n d t h e external world. We a r g u e t h a t t h e
internal r e p r e s e n t a t i o n of affect develops a r o u n d t h e m o t h e r ' s
mirroring of the infant's e x p r e s s i o n s of affect. T h e caregiver's
mirroring display is internalized a n d comes to r e p r e s e n t a n
internal state, b u t it c a n do so only in certain conditions, which
include sufficient a t t u n e m e n t , together with signaling to t h e
infant t h a t t h e affect t h e caregiver is expressing is n o t her own
b u t t h e child's. T h i s a c c o u n t will help u s to u n d e r s t a n d a r a n g e
of severe pathologies.
In c h a p t e r 5, we review developmental r e s e a r c h concerning
t h e development of t h e self a s a g e n t r a t h e r t h a n a s r e p r e s e n t a -
tion. We consider a five-phase model of gradually Increasing
sophistication concerning t h e m e n t a l world, b o t h of t h e self a n d
of others. In t h i s c h a p t e r we confront t h e critical i s s u e of inter-
subjectivity, a fraught notion within developmental theory. We
a r g u e t h a t i n t e r p e r s o n a l a w a r e n e s s is a relatively late develop-
m e n t a l acquisition. A s s u m i n g a developmental progression to-
ward full i n t e r p e r s o n a l a w a r e n e s s offers u s a rich r a n g e of
developmental e x p l a n a t i o n s for psychological d i s t u r b a n c e s . In
general, we m a i n t a i n t h r o u g h o u t t h i s volume t h a t personality
d i s t u r b a n c e s often reflect t h e reemergence of r u d i m e n t a r y forms
of interpersonal a w a r e n e s s — a n a r g u m e n t t h a t is incompatible
with t h e a s s u m p t i o n of a n i n h e r e n t (primary) intersubjectivity.
18 / Introduction

In c h a p t e r 6, we a t t e m p t to apply t h e findings from early

developmental r e s e a r c h m o r e directly to c o n s t r u c t a p s y c h o a n a -
lytic model o f t h e growth of subjectivity. Using clinical a s well a s
empirical evidence, we identify two incompatible a n d probably
alternating ways in w h i c h y o u n g children t r e a t their i n n e r expe-
riences. The m e n t a l world c a n feel either totally real or totally
u n r e a l to a y o u n g child, a n d we suggest t h a t playing with reality,
making t h e real u n r e a l a n d vice versa, is t h e principal a v e n u e for
the development of mentalization. We i n t r o d u c e t h e c a s e s of two
y o u n g children, b o t h treated in psychoanalytic t h e r a p y . "Re-
becca" w a s t h e loved child of y o u n g single m o t h e r , a child w h o
learned in t h e r a p y to play with h e r painful image of h e r father.
This idea h a d initially b e e n too real to b e played with, a n d t h e
feelings it generated o b s t r u c t e d h e r otherwise n o r m a l develop-
ment.
In c h a p t e r 7, we i n t r o d u c e "Mat," a far m o r e deprived child.
Mat's experience of i n a d e q u a t e mirroring left h i m with u n c o n -
tained a n d u n c o n t a i n a b l e affect, w h i c h h e experienced a s p a r t of
h i s bodily self, in a n effort to create a n illusion of self-control. His
encopresis a n d h i s q u a s i - a u t i s t i c features b o t h r e s p o n d e d to a
playful t h e r a p e u t i c stance..
In c h a p t e r 8, we consider t h e special c a s e of adolescence, a
time of high risk for t h e emergence of s e r i o u s d i s t u r b a n c e . We
argue t h a t t h i s is t h e c o n s e q u e n c e of a n increased load on t h e
m e n t a l world o f t h e adolescent, b r o u g h t o n by t h e s u d d e n leap in
cognitive complexity, s i m u l t a n e o u s l y with p r e s s u r e for sepa-
ration from t h e p r i m a r y a t t a c h m e n t figures. We consider two
cases, 'Tony" a n d "Glen." Both were challenged by t h e s h a r p l y
increased complexity of their i n t e r p e r s o n a l worlds, b u t once
again they followed quite different p a t h s . We m a i n t a i n t h a t t h i s
reflected: critical differences in their early experience, w h i c h
equipped one with a far more r o b u s t mentalizing capacity t h a n
the other.
In t h e two following c h a p t e r s , we d i s c u s s severe personality
disorder in a d u l t s , w h i c h we see a s t h e developmental c o n t i n u a -
tion of poorly established mentalized subjectivity.
In c h a p t e r 9, we outline t h e theory t h a t borderline personality
disorder r e s u l t s from t h e inhibition of mentalizing d u e to mal-
t r e a t m e n t in childhood. We expect t h a t t h i s kind of inhibition is
 Introduction / 19

more likely to o c c u r if, b e c a u s e of i n a d e q u a t e early parenting,

t h e p r e c u r s o r s of mentalization were n o t firmly established.
Interpersonal interpretive p r o c e s s e s t h a t developmentally ante-
d a t e mentalization a p p e a r to govern t h e behavior of individuals
with BPD, a t least within a t t a c h m e n t relationships. In c h a p t e r
10, we link t h e failure of mentalization to a distortion in t h e
s t r u c t u r i n g of t h e self; failures of early a t t u n e m e n t a r e expected
to c a u s e disorganization within t h e s t r u c t u r e of t h e self-repre-
sentation. Combined with t r a u m a , t h e s e limitations in t h e integ-
rity of t h e self c a n c a u s e massive d i s r u p t i o n in relationships.
Two c a s e s a r e p r e s e n t e d . In t h e first case, "Emma," lack of
mentalization w a s evident in h e r t r e a t m e n t of h e r own body—her
suicidality a n d m i s m a n a g e m e n t of h e r chronic physical illness.
T h e disorganization of h e r self-structure, w h e n externalized onto
her body, led to a profound distortion of t h e link to h e r physical
experiences. T h e second case, "Henrietta," h a d a history of vio-
lence a g a i n s t a lover, a s well a s self-destructiveness. Her func-
tioning a t a prementalistic level profoundly colored h e r analytic
relationship. In t h i s c h a p t e r we also consider t h e implications of
a disorganized self-structure, with very limited capacity for m e n -
talization, for o u r u n d e r s t a n d i n g of certain transference a n d
countertransference phenomena.
Finally, in c h a p t e r 11, we consider four m o r e t h e r a p e u t i c
e n c o u n t e r s . E a c h illustrates in a different way t h e centrality of
mentalized affectivity in t h e c o u r s e of psychoanalytic therapy.
The a i m of t h i s c h a p t e r is to illustrate t h e way misconnections
between p r i m a r y a n d second-order r e p r e s e n t a t i o n of affect c a n
generate d i s t u r b a n c e s of self-development, which were earlier
argued to be t h e c o n s e q u e n c e s of i n a c c u r a t e mirroring. To a d -
d r e s s s u c h pathologies, t h e t h e r a p y m u s t s i m u l t a n e o u s l y acti-
vate p r i m a r y a n d s e c o n d a r y r e p r e s e n t a t i o n s of affect. T h e c a s e s
illustrate t h e i m p o r t a n c e of t h e integration of affect a n d cogni-
tion in t h e practice of psychoanalytic psychotherapy. T h r o u g h
developing s e c o n d - o r d e r r e p r e s e n t a t i o n s for emotional s t a t e s we
c a n come to experience o u r subjectivity in a way t h a t bridges two
f u n d a m e n t a l n e e d s in h u m a n beings. O n t h e o n e h a n d , we n e e d
to m a i n t a i n a s e n s e of t h e internal equilibrium between m e n t a l
forces—a struggle t h a t w a s a t t h e h e a r t of F r e u d ' s j o u r n e y of
discovery. O n t h e other, we need to be integrated into t h e social
20 / Introduction

world, in which we m u s t respect t h e s e p a r a t e n e s s of other

minds, while being able also to build flexible bridges a c r o s s t h a t
s e p a r a t e n e s s , to create close emotional a n d working relation-
ships. Therapy only w o r k s w h e n b o t h intrapsychic a n d interper-
sonal a i m s are achieved, a n d t h i s is w h e r e we believe t h a t
mentalizing affectivity plays a vital role.
The Epilogue explores s o m e of t h e implications of o u r ideas
for psychopathology a n d p s y c h o t h e r a p y in general.
PART

T H E O R E T I C A L P E R S P E C T I V E S

In Part I, we offer an introduction to some of the main theoretical

concepts used in this book. The first chapter can be thought of as
an overture. We offer definitions of self-reflective function and
mentalization and, in particular, make the argument that the
capacity to mentalize is a key determinant of a psychological
sense of self. Yet, mentalization is not simply a cognitive concept,
and thus we turn in the second chapter to focus in detail on
different perspectives on affects and affect regulation. We clarify
the meaning of affect regulation and emphasize the distinction
between a basic form of affect regulation where the object is
needed to modulate an affect or affects and a more complex form,
altered by the development of mentalization, where the aim is to
be able to regulate the self. Finally, in the third chapter, we stake
out a defense of an environmental position concerning early
development, which does not contest the evidence for a genetic-
btological position but does challenge some ofthe inferences that
are made from it—especially as they are mistranslated into the
clinical realm. We also propose here a crucial reformulation of
attachment theory: according to our view, a major goal of
attachment is to produce a representational systemfor self-states
through mentalization.
 A t t a c h m e n t a n d Reflective Function:
Their Role in Self-Organization

This c h a p t e r i n t r o d u c e s t h e idea of a relationship between at-

t a c h m e n t p r o c e s s e s a n d t h e development of t h e capacity to
envision m e n t a l s t a t e s in self a n d others—the capacity t h a t is
referred to in t h i s book a s mentalization or reflective function.
T h r o u g h o u t t h i s book, w e develop t h e a r g u m e n t t h a t t h e capac-
ity to mentalize is a key d e t e r m i n a n t of self-organization a n d
affect regulation, a n d we m a i n t a i n t h a t t h i s capacity is acquired
in t h e context of t h e child's early social relationships. Here we
give a n overview of t h e evidence for a n association between t h e
quality of a t t a c h m e n t relationship a n d reflective function in t h e
p a r e n t a n d t h e child. We offer some h y p o t h e s e s a b o u t t h e devel-
o p m e n t of reflection in t h e context of t h e infant-caregiver rela-
tionship. We t h e n i n t e r p r e t t h e s e d a t a a n d speculations in t h e
context of c u r r e n t models of theory-of-mind development.

REFLECTIVE FUNCTION OR MENTALIZATION:

A HISTORICAL CONTEXT

C o n c e p t s a n d i d e a s a r o u n d t h e notion of affect a n d self a b o u n d

a n d have a n extraordinarily rich history in philosophy a n d psy-
chology. Even w i t h o u t a c o m p r e h e n s i v e historical perspective, it

23
24 / Theoretical Perspectives

s e e m s a p p a r e n t t h a t t h e concept of t h e self a n d allied ideas

have, more recently, b e e n experiencing a considerable revival
of interest from social scientists a n d developmentalists (e.g.,
Bracken 1996; Cicchetti a n d Toth 1994). Psychological interest
in t h e self is u s u a l l y traced to W. J a m e s ' s (1890, 1892) distinc-
tion of two a s p e c t s of t h e self: t h e "I" (self a s subject) a n d t h e
"Me" (self a s object). T h e "I" is t h e active a g e n t responsible for
constructing t h e self-concept of "Me." To p a r a p h r a s e in t h e
t e r m s of c u r r e n t cognitive neuroscience, t h e "Me" is t h e m e n t a l
representation, while t h e "I" embodies t h e self a s agent, t h e
m e n t a l p r o c e s s e s or functions t h a t u n d e r p i n r e p r e s e n t a t i o n s of
t h e self (Mandler 1985). T h e "I" organizes a n d i n t e r p r e t s experi-
ence, e n s u r e s t h e experience of continuity t h r o u g h time, c r e a t e s
a s e n s e of freedom or initiative, a n d g e n e r a t e s t h e experiences
leading to t h e d i s t i n c t n e s s of oneself a s a p e r s o n (see c h a p t e r 5).
Modern developmental psychology h a s b r o u g h t u s closer to a full
u n d e r s t a n d i n g of t h e m e n t a l p r o c e s s e s t h a t combine to organize
t h e r e p r e s e n t a t i o n of selfhood.
Developmentalists over t h e p a s t t e n y e a r s h a v e d r a w n o u r
attention to t h e n e a r - u n i v e r s a l a n d r e m a r k a b l e capacity of
y o u n g children to interpret their own a n d others' behavior by
attributing m e n t a l s t a t e s (see c h a p t e r s 3 a n d 4). Reflective
function, referred to in developmental psychology a s "theory of
mind," is t h e developmental acquisition t h a t p e r m i t s children to
respond n o t only to a n o t h e r p e r s o n ' s behavior, b u t to t h e chil-
dren's conception of others' beliefs, feelings, attitudes, desires,
hopes, knowledge, imagination, p r e t e n s e , deceit, intentions,
plans, a n d so on. Reflective function, or mentalization, e n a b l e s
children to "read" o t h e r people's m i n d s (Baron-Cohen 1995;
Baron-Cohen, Tager-Flusberg, a n d C o h e n 1993; Morton a n d
Frith 1995). By doing this, children m a k e people's behavior
meaningful a n d predictable. Their early experiences with other
people enable t h e m to build u p a n d organize multiple s e t s of
self-other r e p r e s e n t a t i o n s . As they learn to u n d e r s t a n d other
people's behavior better, t h e y become able flexibly to activate t h e
representation(s) from t h e s e multiple s e t s t h a t are b e s t suited to
respond to particular interpersonal t r a n s a c t i o n s . T h e t e r m "re-
flective function" (RF) refers to t h e operationalization of t h e
psychological p r o c e s s e s underlying t h e capacity to mentalize—a
 Attachment and Reflective Function / 25

concept t h a t h a s b e e n described in b o t h t h e psychoanalytic

(Fonagy 1989; Fonagy, E d g c u m b e , Moran, Kennedy, a n d Target
1993) a n d cognitive (e.g., Morton a n d Frith 1995) psychology
literatures. Reflective functioning or mentalization is t h e active
expression of t h i s psychological capacity intimately related to
t h e r e p r e s e n t a t i o n of t h e self (Fonagy a n d Target 1995, 1996;
Target a n d Fonagy 1996). RF involves b o t h a self-reflective a n d
a n i n t e r p e r s o n a l c o m p o n e n t t h a t ideally provides t h e individual
with a well-developed capacity to distinguish inner from o u t e r
reality, p r e t e n d from "real" m o d e s of functioning, a n d intra-
p e r s o n a l m e n t a l a n d emotional p r o c e s s e s from interpersonal
communications.
T h e i n t e r d e p e n d e n c e of u n d e r s t a n d i n g applied to o t h e r s a n d
to t h e self w a s highlighted by t h e second pioneer of psychological
self theory, Cooley (1912): "The t h i n g t h a t moves u s to pride a n d
s h a m e is n o t t h e m e c h a n i c a l reflection of ourselves, b u t a n
i m p u t e d s e n t i m e n t , t h e imagined effect of t h i s reflection u p o n
a n o t h e r ' s mind" (p. 153). Developmentally, t h i s m a y be t h o u g h t
to imply t h a t a m e n t a l operation is required in early childhood
to derive t h e self-state from t h e apperception o f t h e m e n t a l state
of t h e other. Exploring t h e m e a n i n g of others' actions is t h e n a
p r e c u r s o r of children's ability to label a n d find meaningful their
own psychological experiences. This ability arguably underlies
the capacities for affect regulation, i m p u l s e control, self-moni-
toring, a n d t h e experience of self-agency—the building blocks of
the organization of t h e self. This b o o k a t t e m p t s to trace t h e
stages of acquisition of reflective function or mentalization, its
roots in a t t a c h m e n t , t h e relationship with t h e development of
self-organization, a n d t h e p a r t i c u l a r role of emotional experi-
ence. T h i s is highlighted in t h e final chapter, on mentalized
affectivity.
The notion of reflective function is rooted in D e n n e t t ' s (1978,
1987, 1988) p r o p o s a l t h a t t h r e e s t a n c e s are available in t h e
prediction of behavior: t h e physical stance, t h e design stance,
a n d t h e intentional s t a n c e . He t a k e s predicting t h e behavior of a
chess-playing c o m p u t e r a s h i s example. At its simplest this c a n
be b a s e d on knowledge of t h e physical properties of t h e m a c h i n e
(the physical stance). T h e design s t a n c e would be b a s e d on
knowledge o f t h e design o f t h e c o m p u t e r , including t h e program-
26 / Theoretical Perspectives

ming t h a t h a d gone into its development. T h e third a p p r o a c h

consists of predicting w h a t might be t h e c o m p u t e r ' s m o s t ra-
tional move. Here we a t t r i b u t e to t h e c o m p u t e r certain beliefs
a n d desires—in other words, regulation by intentional; s t a t e s .
Dennett's t h e s i s is t h a t explanation in t e r m s of s u c h s t a t e s of
m e a n i n g provides good g r o u n d s for predicting h u m a n behavior—
t h e only g r o u n d s accessible to all of u s — t h i s knowledge is em-
bodied in t h e theory of m i n d of folk psychology ( C h u r c h l a n d
1986; Fodor 1987; Mele 1992). l
T h e o r y of mind" is a n interconnected set of beliefs a n d de-
sires, a t t r i b u t e d to explain a p e r s o n ' s behavior. T h e theory-of-
mind concept h a s great explanatory value. Philosophers of m i n d
(Hopkins 1992; Wollheim 1995) h a v e extended D e n n e t t ' s ap-
proach to e x a m i n e u n c o n s c i o u s processes. They illustrated t h a t
one of F r e u d ' s s u b s t a n t i v e c o n t r i b u t i o n s w a s to extend folk
psychology to u n c o n s c i o u s m e n t a l s t a t e s , a theory of u n c o n -
scious mind, t h u s m a k i n g t h o s e a s p e c t s of behavior meaningful
t h a t — u s i n g t h e ordinary c o n s t r u c t s of intentionality—make
little s e n s e (e.g., d r e a m s , n e u r o t i c s y m p t o m s , h u m o r ) . T h e s e
behaviors m a y be u n d e r s t o o d if we a d d u n c o n s c i o u s beliefs,
t h o u g h t s , feelings, a n d desires to o u r everyday model of t h e
mind.
For r e s e a r c h p u r p o s e s , we h a v e operationalized mentalization
a s reflective function (Fonagy et al. 1998): we h a v e developed a
tool by m e a n s of w h i c h t h e ability to give plausible interpretation
of one's own a n d others' behavior in t e r m s of underlying m e n t a l
s t a t e s c a n be m e a s u r e d . This implies a w a r e n e s s t h a t experi-
ences give rise to certain beliefs a n d emotions, t h a t p a r t i c u l a r
beliefs a n d desires tend to r e s u l t in certain k i n d s of behavior,
t h a t t h e r e are t r a n s a c t i o n a l relationships between beliefs a n d
emotions, a n d t h a t p a r t i c u l a r developmental p h a s e s or relation-
s h i p s are associated with certain feelings a n d beliefs. We do n o t
expect a n individual to articulate t h i s theoretically, b u t to dem-
o n s t r a t e it in t h e way they interpret events within a t t a c h m e n t
relationships w h e n a s k e d to do so. Individuals differ in t h e

1
Dennett's formulation is perhaps unnecessarily restrictive (Bolton and Hill
1996). It does not address predicting the behavior of systems that do not
function rationally.
 Attachment and Reflective Function / 27

extent to which they a r e able to go beyond observable p h e n o m -

e n a to give a n a c c o u n t of their own or others' actions in t e r m s of
beliefs, desires, p l a n s , a n d so on. This cognitive capacity is a n
i m p o r t a n t d e t e r m i n a n t of individual differences in self-organiza-
tion a s it is intimately involved with m a n y defining features of
selfhood s u c h a s self::consciousness, a u t o n o m y , freedom, a n d
responsibility (Bolton a n d Hill 1996; C a s s a m 1994). Intentional
s t a n c e , in t h e b r o a d s e n s e considered h e r e (i.e., including a p p a r -
ently irrational u n c o n s c i o u s acts), c r e a t e s t h e continuity of self-
experience t h a t is t h e u n d e r p i n n i n g of a c o h e r e n t self-structure.
It is i m p o r t a n t n o t to conflate reflective function with intro-
spection. Bolton a n d Hill (1996) note t h a t t h e w e a k n e s s of in-
trospection is to define m e n t a l s t a t e s in t e r m s of c o n s c i o u s n e s s
or self-report r a t h e r t h a n , a s here, in t e r m s of their capacity to
m a k e s e n s e of, a n d t h u s regulate, behavior. Introspection or self-
reflection is quite different from reflective function a s t h e latter is
a n a u t o m a t i c procedure, u n c o n s c i o u s l y invoked in interpreting
h u m a n - action. We see introspection a s a n overlearned skill,
which m a y be systematically misleading in a way t h a t is m u c h
more difficult to detect a n d correct t h a n m i s t a k e s in c o n s c i o u s
a t t r i b u t i o n s would be. T h e s h a p e a n d coherence lent to self-
organization b y reflective function is entirely outside a w a r e n e s s ,
in c o n t r a s t to introspection, w h i c h h a s a clear impact on ex-
perience of oneself. Knowledge of m i n d s in general, r a t h e r t h a n
self-knowledge, is,the defining feature; introspection is t h e appli-
cation o f t h e theory of m i n d to one's own m e n t a l states.

The P s y c h o a n a l y t i c C o n c e p t of R e f l e c t i v e F u n c t i o n

Various n o t i o n s h a v e b e e n introduced in t h e psychoanalytic

literature to d e n o t e m e n t a l p r o c e s s e s t h a t overlap with t h e con-
s t r u c t of mentalization, u n d e r p i n n e d by RF. S p a c e does n o t
permit a n e x h a u s t i v e review, b u t some of t h e s e should be men-
tioned, a s t h e y m a y a s s i s t t h e r e a d e r in m a k i n g links between
t h e c u r r e n t c o n s t r u c t s a n d t h o s e proposed by other writers.
Mentalization h a s b e e n described in t h e psychoanalytic litera-
t u r e u n d e r v a r i o u s h e a d i n g s (see t h e excellent review by
Lecours a n d B o u c h a r d 1997). All s u c h notions derive from
28 / Theoretical Perspectives

F r e u d ' s initial concept of "Bindung" or linking. In h i s distinc-

tion between primary a n d s e c o n d a r y processes, F r e u d (1911b)
stressed b o t h t h a t "Bindung" w a s a qualitative c h a n g e from a
physical (immediate) to a psychic associative quality of linking
a n d t h a t t h e psychic working o u t or r e p r e s e n t i n g of i n t e r n a l
state of affairs (conceived of in energic terms) failed in v a r i o u s
ways (Freud 1914c). Some m i g h t a r g u e t h a t Melanie Klein's
notion of t h e depressive position (Klein 1945) is a t least analo-
gous to t h e notion of t h e acquisition of RF, w h i c h necessarily
entails t h e recognition of h u r t a n d suffering in t h e other a s well
a s t h a t of one's own role in t h e process. Wilfred Bion (1962a,
1962b), in describing t h e "alpha-function," delineated t h e t r a n s -
formation of i n t e r n a l events experienced a s concrete ("beta-ele-
ments") into tolerable t h i n k a b l e experiences. Similarly to t h e
c u r r e n t conception, Bion also s a w t h e m o t h e r - c h i l d relationship
a s a t t h e root of t h e symbolic capacity. Winnicott (1962) also
recognized t h e i m p o r t a n c e of t h e caregiver's psychological un-
d e r s t a n d i n g of t h e infant for t h e emergence of t h e t r u e self.
Winnicott w a s also foremost a m o n g psychoanalytic t h e o r i s t s of
self-development (e.g., Fairbairn 1952; Kohut 1977) in recogniz-
ing t h a t t h e psychological self develops t h r o u g h t h e perception
of oneself in a n o t h e r p e r s o n ' s m i n d a s t h i n k i n g a n d feeling.
P a r e n t s w h o c a n n o t reflect with u n d e r s t a n d i n g on their chil-
d r e n ' s i n n e r experiences a n d r e s p o n d accordingly deprive their
children of a core psychological s t r u c t u r e , w h i c h t h e y n e e d to
build a viable s e n s e of self.
Independently, F r e n c h p s y c h o a n a l y s t s developed a notion of
mentalization t h a t w a s largely formulated from t h e economic
point of view. Pierre Marty d i s c u s s e d mentalization a s a protecr
rive buffer in t h e p r e c o n s c i o u s s y s t e m t h a t p r e v e n t s progressive
disorganization (Marty 1968). He considers mentalization a s
connecting drive excitations a n d m e n t a l r e p r e s e n t a t i o n s a n d
thereby creating b o t h "fluidity" a n d "constancy" (Marty 1990,
1991). Mentalization e n s u r e s freedom in t h e u s e of a s s o c i a t i o n s
a s well a s p e r m a n e n c e a n d stability. At t h e s a m e time Pierre
Luquet (1981, 1988) d i s c u s s e d t h e development of different
forms of thinking a n d t h e reorganization of i n n e r experience
alongside t h i s development. In h i s c h a p t e r on a theory of lan-
guage (Luquet 1987), h e distinguished p r i m a r y mentalization
 Attachment and Reflective Function / 29

(which we would consider t h e a b s e n c e of RF) from s e c o n d a r y

symbolic mentalization. While this form of mentalization w a s still
seen a s closely connected to sensory d a t a a n d primary u n c o n -
scious fantasies, it w a s nevertheless also s e e n a s representative
of t h e s e p r o c e s s e s a n d observable in d r e a m s , art, a n d play. His
third level w a s verbal t h o u g h t , w h i c h h e considered m o s t d i s t a n t
from bodily processes. Similar ideas were proposed by Andre
Green (1975), H a n n a Segal (1957), a n d J o y c e McDougall (1978);
a n d , m o r e recently, by A u e r b a c h (1993; A u e r b a c h a n d Blatt
1996), B u s c h (1995), a n d F r o s c h (1995).

T h e o r i e s C o n c e r n i n g t h e D e v e l o p m e n t of M e n t a l i z a t i o n

B a r o n - C o h e n a n d S w e t t e n h a m appropriately a s k : "how o n e a r t h
c a n y o u n g children m a s t e r s u c h a b s t r a c t c o n c e p t s a s belief (and
false belief) w i t h s u c h ease, a n d roughly a t t h e s a m e t i m e t h e
world over" (1996, p. 158)? Their a n s w e r is t h a t of modularity
theorists, along t h e lines of C h o m s k y ' s solution to t h e problem of
t h e acquisition of a knowledge of syntax. They p o s t u l a t e a n
i n n a t e (learning) m e c h a n i s m with a specific location in t h e b r a i n
(see also B a r o n - C o h e n 1995; Leslie 1994; G. Segal 1996). Other
c u r r e n t psychological theories s t r e s s t h e cognitive p r e c u r s o r s of
theory of m i n d . S o m e favor t h e folk-psychology, theory-theory,
a p p r o a c h , w h i c h a s s u m e s t h a t t h e child evolves a scientific-
theory-like n e t w o r k of i n t e r d e p e n d e n t propositions a b o u t t h e
mind on -the b a s i s of experience (e.g., Botterill 1996; Gopnik
1996). O t h e r s a s s u m e t h a t theory of m i n d is acquired via simula-
tion of t h e m e n t a l s t a t e of t h e other, either t h r o u g h m a k i n g
inferences from w h a t we ourselves would do in t h e imagined
c i r c u m s t a n c e s (e.g., G o l d m a n 1993; P. L. Harris 1992) or a n
even m o r e radical a s s u m p t i o n of imagined transformation
into t h e o t h e r w h i c h does n o t involve introspection or inference
(Gordon 1992, 1995). These, a n d o t h e r theories, a r e considered
in greater detail in c h a p t e r 5.
Both s i m u l a t i o n a n d t h e o r y - t h e o r y models m a y a t first glance
a p p e a r to e m p h a s i z e social-learning a s p e c t s of t h e development
of mind-reading, b u t on closer s c r u t i n y their focus is a t t h e level
of m e c h a n i s m r a t h e r t h a n content. They question h o w a n d w h e n
30 / Theoretical Perspectives

t h e child acquires knowledge of other m i n d s in a n a b s t r a c t s e n s e

a n d do not a s k w h a t t h e child feels a b o u t t h e m e n t a l s t a t e s h e
e n c o u n t e r s in others. Yet, in this context a t least, t h e q u e s t i o n of
knowledge a n d t h a t of emotional investment a r e evidently closely
related. The child m a y k n o w w h a t t h e o t h e r feels b u t care little
or n o t a t all a b o u t this; alternatively, t h i s information may, for
some y o u n g s t e r s , be a n i s s u e of survival. T h e emotional signifi-
cance of m e n t a l s t a t e s d e t e r m i n e s t h e evolution of t h e capacity
or s t r u c t u r e available for processing, b u t t h i s is n o t u s u a l l y
a d d r e s s e d . C u r r e n t models of theory-of-mind development t e n d
to portray t h e child a s a n isolated processor of information, w h o
c o n s t r u c t s a theory of m i n d u s i n g biological m e c h a n i s m s t h a t
have a n expectable failure r a t e w h e r e t h e child's e n d o w m e n t is
less t h a n optimal.
From t h e viewpoint of developmental psychopathology a n d its
psychosocial t r e a t m e n t , this is a b a r r e n picture, w h i c h ignores
t h e central role of t h e child's emotional relationship with t h e
p a r e n t s in fostering t h e capacity to u n d e r s t a n d interactions in
psychological t e r m s . T h e development of children's u n d e r s t a n d -
ing of m e n t a l s t a t e s is e m b e d d e d within t h e social world of t h e
family, with its network of complex a n d often intensely emotion-
ally charged relationships, w h i c h are, after all, m u c h of w h a t
early reflection n e e d s to c o m p r e h e n d . Therefore it s h o u l d n o t
s u r p r i s e u s t h a t t h e n a t u r e of family interactions, t h e quality of
p a r e n t a l control (Dunn, Brown, Slomkowski, Telsa, a n d Young-
blade 1991), p a r e n t a l talk a b o u t emotions (Denham, Zoller, a n d
C o u c h o u d 1994), a n d t h e d e p t h of p a r e n t a l d i s c u s s i o n involving
affect (Dunn, Brown, a n d Beardsall 1991) are all strongly associ-
ated with t h e acquisition of t h e intentional s t a n c e in obser-
vational studies. T h e involvement of t h e family in t h e child's
acquisition of a theory of m i n d is further highlighted- by t h e
r o b u s t finding t h a t t h e p r e s e n c e of older siblings in t h e family
a p p e a r s to improve t h e child's performance on a r a n g e of false-
belief t a s k s (Jenkins a n d Astington 1996; Perner, Ruffman, a n d
Leekam 1994; Ruffman, Perner, Naito, Parkin, a n d Clements
1998).
Modular a c c o u n t s of theory-of-mind development h a v e diffi-
culty with s u c h d a t a . Neither t h e t h e o r y - t h e o r y n o r t h e simula-
tion a c c o u n t adequately covers t h e social origins of t h i s critical
 Attachment and Reflective Function / 31

a s p e c t of self-organization. In t h e theory-theory a c c o u n t , m e n t a l
c o n c e p t s a r e t h o u g h t to develop within a n e t w o r k of interde-
p e n d e n t c o n c e p t s on t h e b a s i s of d a t a from t h e social world, b u t
t h e s o c i a l w o r l d does n o t generally "give" concepts to t h e child;
r a t h e r , it provides h i m with d a t a for concept-building. In t h e
simulation model, m e n t a l - s t a t e c o n c e p t s a r e t h o u g h t to arise
from introspection, b u t t h i s begs t h e question of how children
come to t h i n k of their own m e n t a l s t a t e s a s feelings, beliefs,
wishes, a n d so on. This c h a p t e r a n d t h e book a s a whole explore
t h e role of p a r e n t - c h i l d relationships in t h e transformation of
prereflective experience of m e n t a l s t a t e s into reflective u n d e r -
s t a n d i n g of t h e m . Both social models of m i n d - r e a d i n g m a y have
their place here; t h e p r e d o m i n a n c e of one or other r o u t e to
u n d e r s t a n d i n g t h e m i n d m a y be a function of individual differ-
ences between children, b u t , in o u r view, a satisfactory model
m u s t b e rooted in t h e child's relationships with a t t a c h m e n t
figures.

T H E DEVELOPMENTAL ROOTS
OF REFLECTIVE FUNCTION IN INFANCY

The "Teleological" S t a n c e

There is general a g r e e m e n t t h a t self-organization initially entails

t h e integration of body-related experiences, defining t h e physical
b o u n d a r i e s of self a n d world (e.g., Brownell a n d Kopp 1991).
Once t h e physical self h a s b e e n established, social exchanges,
t h e identifications of social b o u n d a r i e s , a n d , s o m e w h a t later,
the identification of social causality become central self-func-
tions. T h e p a r e n t ' s recognition of t h e child's intentional s t a n c e
(Dennett 1978), however, is c o m m u n i c a t e d nonverbally, begin-
ning a t birth. Between b i r t h a n d t h e age of 5 m o n t h s , face-to-
face e x c h a n g e s of affective signals between infant a n d caregiver
(Beebe, L a c h m a r m , a n d Jaffe 1997; Tronick 1989) play a key role
in the development of t h e child's r e p r e s e n t a t i o n of affect.
For example, u s i n g a microanalytic observational paradigm,
t h e p r o g r a m of w o r k reported by Beatrice Beebe, F r a n k Lach^
32 / Theoretical Perspectives

m a n n , a n d J o s e p h Jaffe over t h e p a s t two d e c a d e s h a s d e m o n -

strated, a m o n g o t h e r things:

1. t h a t t h e h u m a n infant e n t e r s into interaction with t h e care-

giver, w h i c h involves b o t h self-regulation a n d sensitivity to
t h e s t a t e of t h e other;
2. t h a t a t t h e level of facial expression t h e r e is a rapid, m u t u a l l y
influencing p r o c e s s w h e r e t h e infant's behavior over a
twelfth- of- a-second time period is predicted by t h e m o t h e r ' s
a n d vice versa, p r e s u m a b l y on t h e b a s i s of s c h e m a t a of t h e
anticipated reaction of t h e other;
3. t h a t t h e s p a c e a n d degree of c o n t a c t between infant a n d
caregiver is systematically altered by b o t h , again a p p a r e n t l y
on t h e b a s i s of expectancies;
4. t h a t a higher degree of coordination predicts precocious cog-
nitive performance, w h e r e a s lower levels of coordination a r e
optimal for s e c u r e a t t a c h m e n t a n d e a s y t e m p e r a m e n t ;
5. t h a t interaction (coordination) with a s t r a n g e r a t 4 m o n t h s is
more predictive of t h e infant's behavior with t h e m o t h e r in t h e
S t r a n g e Situation (SSn) 2 a t 1 year t h a n is t h e s a m e m e a s u r e
with t h e r m o t h e r herself.

Interactions a t t h i s stage m a y be a r g u e d to be presymbolic in

t h a t t h e y a r e n o t mentalized; t h e infant is n o t required to repre-
s e n t t h e t h o u g h t s or feelings of t h e caregiver. However, t h e y
involve reference to future s t a t e s , s u c h a s goals, in explaining
t h e behavior of t h e other. T h u s t h e y c a n b e u s e d to predict
behavior, a l t h o u g h t h e s e s t r u c t u r e s would b e limited in their
capacity to modify behavior. The m e n t a l models t h u s created
(Johnson-Laird a n d Byrne 1991, 1993) do n o t have t h e informa-

2
The Strange Situation is a 20-minute laboratory test where the child Is
exposed to two "minuscule separations" of a maximum of 3 minutes each. Mary
Ainsworth and her colleagues (Ainsworth et al. 1978) found that the majority of
middle-class 1-year-old children respond to the mother with proximity-seeking
and relief at reunion (securely attached—B infants), but about 25% respond
with subtle signs of indifference (anxious avoldantly attached—A infants), and a
further 15% respond with proximity-seeking but little relief at reunion (anxious
reslstantly attached—C infants).

i
 Attachment and Reflective Function / 33

tion required to c h a n g e t h e other's s t a t e of m i n d . This would

require a n intentional s t a n c e (Dennett 1983) where, in addition
to prediction, t h e p e r s o n ' s beliefs a n d desire s t a t e s a r e repre-
sented. Work by Gergely a n d Csibra (1996; Gergely, Nadasdy,
Csibra, a n d Biro 1995) s u g g e s t s t h a t by t h e second half of t h e
first y e a r infants' perception of social contingencies is "teleologi-
caT in t h a t t h e y m a k e reference to future s t a t e s (goals) a s
explanatory entitles in t h e interpretation of behavior b a s e d on
t h e principle of "rational action." (This work is reviewed in full in
c h a p t e r 5.) Infants apply t h e ideological s t a n c e t o . h u m a n a n d
n o n h u m a n objects alike. S t u d i e s by Gergely a n d Csibra (1997)
d e m o n s t r a t e t h a t infants e x p r e s s s u r p r i s e w h e n n o n h u m a n b u t
moving objects (e.g., various-sized d i s k s in a computer-gener-
ated a n i m a t e d display) a p p e a r to a c t "irrationally"—not choosing
the optimal action, given specific goals a n d reality constraints.
The infant is a s s u m e d to extend teleological models beyond
the prediction of h u m a n behavior. Teleological models, however,
evolve into mentalizing o n e s in t h e restricted d o m a i n of h u m a n
action. They b e c o m e fully mentalizing once r e p r e s e n t a t i o n s of
future goal s t a t e s come to be t h o u g h t of a s desires a n d con-
s t r a i n t s on reality come to be t h o u g h t of in t e r m s of t h e agent's
belief a b o u t physical reality. T h e infant's behaviors in dyadic
interactions a r e u n d e r p i n n e d by their evolving model of rational
action on t h e p a r t of t h e caregiver. We a r g u e t h a t t h e develop-
m e n t from teleological to mentalizing models will depend on t h e
quality of i n t e r p e r s o n a l interactions between t h e infant a n d t h e
parent. It s h o u l d b e noted t h a t while s u c h models m a y merely
represent rational action, it is t h e perceived r a t h e r t h a n a c t u a l
rationality of a n a c t t h a t defines t h e teleological model. T h u s ,
m i s a p p r e h e n s i o n of reality c o n s t r a i n t s (e.g., a s s u m e d danger-
ousness) will provide a n d create a model where action t h a t is
clearly irrational from a n external s t a n d p o i n t is nevertheless
seen a s b a s e d on t h e principle of rational action. The predictive
significance o f t h e infant's r e s p o n s e , t o a s t r a n g e r (Beebe et al.,
1997) s u g g e s t s t h a t r e p r e s e n t a t i o n s (working models) of self-
other relations, even w h e n n o t yet mentalized, begin to vary in
quality in t h e first year, a n d t h i s quality is related to i n f a n t -
p a r e n t interactions, a s observed in t h e laboratory situation. If
sufficiently c o h e r e n t to be generalized to other relationships in
34 / Theoretical Perspectives

characteristic ways, they m a y index p r o c e s s e s t h a t a r e crucial to

t h e creation of a s e c u r e m o t h e r - i n f a n t b o n d .

Representational Mapping

Representational m a p p i n g is likely to u n d e r p i n t h e g r a d u a l move

in infancy from teleological to mentalizing models of m i n d . Be-
tween t h e ages of 6 a n d 18 m o n t h s , t h e child b e c o m e s increas-
ingly able to m a t c h h i s m e n t a l s t a t e with t h a t of t h e caregiver
vis-a-vis a third object or person, as, for example, in requesting
joint attention (Bretherton 1991a). T h e c o m m u n i c a t i o n is evi-
dently deliberate (goal-oriented) since children m a y b e observed
a t this p h a s e trying to repair failed communicative b i d s (Golin-
koff 1986) a n d t h u s showing a t least r u d i m e n t a r y recognition of
a w a r e n e s s a n d agency in self a n d other, including feelings,
perceptions, a n d i n t e n t i o n s (Wellman 1993). Neisser (1991) sug-
gested t h a t , b a s e d on p e r c e p t u a l processes, two p r e c o n c e p t u a l
a s p e c t s of t h e self emerge: t h e ecological a n d t h e interpersonal.
While t h e former involves self-awareness in reference to visuo-
spatial, tactile, auditory, a n d other p e r c e p t u a l information
concerning t h e child's nonsocial s u r r o u n d i n g s , t h e latter is gen-
erated via t h e coperception of a c t i o n s of t h e self a n d related
contingent actions of others. Taking S t e r n ' s (1985) a n d Neisser's
formulation of t h e interpersonal self together, we c a n identify
t h r e e a s p e c t s of t h e intersubjective development of t h e
self, which M u n d y a n d Hogan (1994) t e r m " i n s t r u m e n t a l action
states," "sensory or perceptual action states," a n d "affective ac-
tion states." Rogers a n d Pennington (1991) offered a model o f t h e
cognitive b a s i s for s u c h a n intersubjective p r o c e s s i n . t h e i r con-
cept of r e p r e s e n t a t i o n a l m a p p i n g (the p r o c e s s of coordinating
r e p r e s e n t a t i o n s of self a n d other), w h i c h is t h o u g h t to underlie
t h e s h a r i n g of affect, attention, a n d higher-order a s p e c t s of
cognition s u c h a s beliefs. T h e existence of imitation skills from
t h e n e o n a t a l stage r e p r e s e n t s s t r o n g evidence for t h e model
(Meltzoff a n d Gopnik 1993). T h e acquisition of a n appreciation of
m e n t a l s t a t e s , however, goes b e y o n d mirroring.
T h e development of a n u n d e r s t a n d i n g of affect in self a n d
other m a y be a good illustration of t h e role of r e p r e s e n t a t i o n a l

at
 Attachment and Reflective Function / 35

m a p p i n g in t h e development of reflective abilities (Gergely a n d

Watson 1996; Target a n d Fonagy 1996). Anxiety, for example, is
for t h e .infant a "confusing m i x t u r e of physiological c h a n g e s ,
ideas, a n d behaviors. W h e n t h e m o t h e r reflects, or mirrors, t h e
child's anxiety, t h i s perception organizes t h e child's experience,
a n d h e n o w "knows" w h a t he is feeling. T h e m o t h e r ' s r e p r e s e n t a -
tion of t h e infant's affect is r e p r e s e n t e d by t h e child a n d is
m a p p e d o n t o t h e r e p r e s e n t a t i o n of its self-state. T h e discrepancy
between t h e s e is helpful insofar a s it provides organization for
the self-state, a n d t h u s t h e caregiver's mirroring c a n become t h e
higher-order r e p r e s e n t a t i o n o f t h e child's experience. Within this
model, mirroring would b e expected to fail if it is either too close
to t h e infant's experience or too remote from it. If t h e mirroring is
too a c c u r a t e , t h e perception itself c a n become a s o u r c e of fear,
a n d it loses its symbolic potential. If it is a b s e n t , n o t readily
forthcoming, o r c o n t a m i n a t e d with t h e m o t h e r ' s own p r e o c c u p a -
tion, t h e p r o c e s s of self-development is profoundly compromised.
We m a y p r e s u m e t h a t individuals for w h o m t h e s y m p t o m s of
anxiety signify c a t a s t r o p h e s (e.g., h e a r t a t t a c k , i m m i n e n t d e a t h ,
etc.) have m e t a r e p r e s e n t a t i o n s of their emotional r e s p o n s e s
which c a n n o t limit their intensity t h r o u g h symbolization, per-
h a p s b e c a u s e t h e original mirroring by t h e primary caregiver
exaggerated t h e infant's emotions.
Although this idea is speculative, it is empirically testable. It
might help to a n s w e r t h e t h o r n y question of why individuals
with p a n i c disorders a r e so t h r e a t e n e d by physiologically rela-
tively mild d i s t u r b a n c e s of their equilibrium. T h e suggestion
here is t h a t t h e m e t a r e p r e s e n t a t i o n , or symbolic representation,
of affect in t h e s e c a s e s c o n t a i n s too m u c h of t h e p r i m a r y experi-
ence; hence, i n s t e a d of labeling t h e experience in s u c h a way a s
to enable t h e individual to a t t e n u a t e its intensity, it t e n d s to
stimulate a n d exacerbate s y m p t o m s of t h e affect state, which in
t u r n a c c e n t u a t e s t h e s e c o n d a r y expression, in a cycle of escalat-
ing panic. 3 In o n e s t u d y (Fonagy, Steele, et al. 1995), we h a v e
confirmed t h a t m o t h e r s w h o soothe their distressed 8 - m o n t h -
olds m o s t effectively following a n injection rapidly reflect t h e

3
In terms of linguistic theory, one may say that the slgnifler is not sufficiently
"demotlvated"—in other words, it resembles the signified too closely.
36 / Theoretical Perspectives

child's emotion, b u t t h i s mirroring is c o n t a m i n a t e d by displays

of affect t h a t a r e incompatible with t h e child's c u r r e n t feeling
(smiling, questioning, mocking display, a n d t h e like). In display-
ing s u c h "complex, affect" (Fonagy a n d Fonagy 1987), t h e y en-
s u r e t h a t t h e infant recognizes their emotion a s analogous, b u t
not identical, to their experience, a n d t h u s t h e p r o c e s s of symbol
formation m a y begin. In t h i s way, t h e r e p r e s e n t a t i o n a l m a p p i n g
between affect of self a n d emotions of others, t h e e x c h a n g e of
affect between y o u n g child a n d caregiver, provides a u n i q u e
s o u r c e of information to t h e child a b o u t h i s own i n t e r n a l states.
We suggest t h a t t h e m e a n i n g or s e n s e of affect develops o u t of
t h e integrated r e p r e s e n t a t i o n of t h e affect in self a n d other.
The combination of t h e r e p r e s e n t a t i o n of self-experience a n d
t h e r e p r e s e n t a t i o n of t h e reaction of t h e caregiver e l a b o r a t e s t h e
child's teleological model of t h e m i n d a n d ultimately e n a b l e s h i m
to u n d e r s t a n d affective displays in others, a s well.as arriving a t
t h e regulation of h i s own emotions. T h e r e p r e s e n t a t i o n a l m a p -
ping of emotion displays a n d self-experience is s e e n here a s a
prototypical i n s t a n c e of caregiver sensitivity, which, a s we at-
t e m p t to d e m o n s t r a t e , is likely to be a n i m p o r t a n t c o m p o n e n t of
t h e development of mentalizing. T h e sensitivity of t h e caregiver
p r o m p t s t h e child to begin organizing self-experience according
to c l u s t e r s of r e s p o n s e s t h a t will eventually come to be verbally
labeled a s specific emotions (or desires). T h e high contingent
r e s p o n s e is t h e m e a n s by w h i c h t h i s m a p p i n g c a n t a k e place.
T h e child's affective experiences a r e given further m e a n i n g by
becoming associated with c l u s t e r s of reality c o n s t r a i n t s with-
in t h e p a r e n t - i n f a n t interaction (leading to r u d i m e n t a r y beliefs
a b o u t t h e c a u s e s a n d c o n s e q u e n c e s of h i s emotional state).

REFLECTIVE FUNCTION
AND ATTACHMENT SECURITY IN T H E PARENT

A t t a c h m e n t theory, developed by J o h n Bowlby (1969, 1973,

1980), p o s t u l a t e s a universal h u m a n need to form close
affectional b o n d s . At its core is t h e reciprocity of early relation-
ships, which is a precondition of n o r m a l development probably
 Attachment and Reflective Function / 37

In all m a m m a l s , including h u m a n s (Hofer 1995). T h e a t t a c h -

m e n t behaviors of t h e h u m a n infant (e.g., proximity-seek-
ing, smiling, clinging) a r e reciprocated by a d u l t a t t a c h m e n t
behaviors (touching, holding, soothing), a n d t h e s e r e s p o n s e s
s t r e n g t h e n t h e a t t a c h m e n t behavior of t h e infant toward t h a t
particular a d u l t . T h e activation of a t t a c h m e n t behaviors de-
p e n d s on t h e infant's evaluation of a r a n g e of environmental
signals, w h i c h r e s u l t s in t h e feeling of security or insecurity. T h e
experience of security is t h e goal of t h e a t t a c h m e n t system,
which is t h u s first a n d foremost a regulator of emotional expe-
rience (Sroufe 1996). In t h i s s e n s e it lies a t t h e h e a r t of m a n y
forms of m e n t a l disorder a n d t h e entire p s y c h o t h e r a p e u t i c
enterprise.
None of u s is b o r n with t h e capacity to regulate o u r own
emotional reactions. A dyadic regulatory s y s t e m evolves where
the infant's signals of m o m e n t - t o - m o m e n t c h a n g e s in h i s s t a t e
are u n d e r s t o o d a n d r e s p o n d e d to by t h e caregiver, thereby
achieving their regulation. T h e infant l e a r n s t h a t a r o u s a l in t h e
presence of t h e caregiver will n o t lead to disorganization beyond
his coping capabilities. T h e caregiver will b e t h e r e to reestablish
equilibrium. In s t a t e s of uncontrollable arousal, t h e infant will
come to seek physical proximity to t h e caregiver in t h e h o p e of
soothing a n d t h e recovery of h o m e o s t a s i s . T h e infant's behavior
by the e n d of t h e first year is purposeful a n d a p p a r e n t l y b a s e d
on specific expectations. His p a s t experiences with t h e caregiver
are aggregated into r e p r e s e n t a t i o n a l s y s t e m s t h a t Bowlby (1973)
termed "internal working models" (IWM). T h u s , t h e a t t a c h m e n t
system is a n o p e n biosocial h o m e o s t a t i c regulatory system.

P A T T E R N S O F A T T A C H M E N T IN I N F A N C Y

The second great pioneer of a t t a c h m e n t theory. Mary Ainsworth

(1985; Ainsworth, Blehar, Waters, a n d Wall 1978), developed t h e
well-known laboratory-based p r o c e d u r e for observing infants'
internal working models in action. Infants, briefly s e p a r a t e d
from their caregiver in a situation unfamiliar to them, s h o w one
of four p a t t e r n s of behavior: (a) Infants classified a s secure
38 / Theoretical Perspectives

explore readily in t h e p r e s e n c e of t h e primary caregiver, are

a n x i o u s in t h e p r e s e n c e of t h e s t r a n g e r a n d avoid her, are
distressed by their caregiver's brief a b s e n c e , rapidly seek contact
with h e r afterwards, a n d a r e r e a s s u r e d by t h i s contact, r e t u r n -
ing to their exploration, (b) Some infants, w h o a p p e a r to be m a d e
less a n x i o u s by separation, m a y n o t s e e k proximity with -the
caregiver following s e p a r a t i o n a n d m a y n o t prefer h e r over t h e
stranger; t h e s e infants a r e designated anxious /avoidant (c) Anx-
ious/resistant infants s h o w limited exploration a n d play, t e n d to
be highly d i s t r e s s e d by t h e separation, a n d have great difficulty
in settling afterwards, showing struggling, stiffness, c o n t i n u e d
crying, or fuss in a passive way. T h e caregiver's p r e s e n c e or
a t t e m p t s a t comforting fail to r e a s s u r e , a n d t h e infant's anxiety
a n d a n g e r a p p e a r to prevent h i m from deriving comfort from
proximity. S e c u r e infants' behavior is b a s e d on t h e experience of
well-coordinated, sensitive i n t e r a c t i o n s w h e r e t h e caregiver is
rarely overarousing a n d is able to restabilize t h e child's disor-
ganizing emotional r e s p o n s e s . Therefore, they r e m a i n relatively
organized in stressful s i t u a t i o n s . Negative emotions feel less
t h r e a t e n i n g a n d c a n be experienced a s meaningful a n d c o m m u -
nicative ( G r o s s m a n n , G r o s s m a n n , a n d S c h w a n 1986; Sroufe
1996). A n x i o u s / a v o i d a n t l y a t t a c h e d children a r e p r e s u m e d to
h a v e h a d experiences where their emotional a r o u s a l w a s n o t
restabilized by t h e caregiver, or w h e r e t h e y were overaroused
t h r o u g h intrusive parenting; therefore, t h e y overregulate their
affect a n d avoid s i t u a t i o n s t h a t a r e likely to be distressing.
A n x i o u s / r e s i s t a n t l y a t t a c h e d children underregulate, heighten-
ing their expression of distress, possibly in a h effort to elicit t h e
expectable r e s p o n s e of t h e caregiver. There is a low t h r e s h o l d for
threat, a n d t h e child b e c o m e s preoccupied with h a v i n g contact
with t h e caregiver b u t is frustrated even w h e n it is available
(Sroufe 1996). (cfl A fourth g r o u p of infants exhibits seeming-
ly undirected behavior, s u c h a s freezing, h a n d - c l a p p i n g , head-
banging, a n d t h e w i s h to escape t h e s i t u a t i o n even in the
p r e s e n c e of t h e caregiver. T h e s e infants a r e referred to a s disor-
ganized/disoriented (Main a n d Solomon 1990). It is generally
held t h a t for s u c h infants t h e caregiver h a s served a s a s o u r c e of
b o t h fear a n d r e a s s u r a n c e , a n d t h u s a r o u s a l of t h e a t t a c h m e n t
behavioral s y s t e m p r o d u c e s s t r o n g conflicting motivations.
 Attachment and Reflective Function / 39

Not surprisingly, a history of prolonged or repeated s e p a r a t i o n

(Chisolm 1998), i n t e n s e m a r i t a l conflict (Owen a n d Cox 1997),
and severe neglect or physical or sexual a b u s e (Carlson,
Cicchetti, B a r n e t t , a n d B r a u n w a l d 1989) is often associated with
this p a t t e r n .

THE ATTACHMENT SYSTEM A S A DETERMINANT

OF LATER INTERPERSONAL RELATIONSHIPS

Bowlby proposed t h a t i n t e r n a l working models of t h e self a n d

others provide prototypes for all later relationships. S u c h models
are relatively s t a b l e a c r o s s t h e lifespan (Collins a n d Read 1994).
Because i n t e r n a l working models function outside a w a r e n e s s ,
they are c h a n g e - r e s i s t a n t (Crittenden 1990). T h e stability of
a t t a c h m e n t is d e m o n s t r a t e d by longitudinal s t u d i e s of infants
assessed with t h e S t r a n g e Situation a n d followed u p in adoles-
cence or y o u n g a d u l t h o o d with t h e Adult Attachment Interview
(AAI) (George, Kaplan, a n d Main 1985). This s t r u c t u r e d clinical
i n s t r u m e n t elicits narrative histories of childhood a t t a c h m e n t
relationships. T h e AAI scoring s y s t e m (Main a n d Goldwyn 1994)
classifies Individuals into Secure/Autonomous, Insecure/Dis-
missing, Insecure/Preoccupied, or Unresolved with respect to
loss or t r a u m a — c a t e g o r i e s b a s e d on t h e s t r u c t u r a l qualities of
narratives of early experiences. While autonomous individuals
value a t t a c h m e n t relationships, coherently integrate memories
into a meaningful narrative, a n d regard t h e s e a s formative,
insecure individuals a r e poor a t integrating memories of experi-
ence with t h e m e a n i n g of t h a t experience. Those dismissing of
a t t a c h m e n t s h o w avoidance by denying memories a n d by idealiz-
ing or devaluing early relationships. Preoccupied individuals
tend to be confused, angry, or fearful in relation to a t t a c h m e n t
figures, s o m e t i m e s still complaining of childhood slights, echo-
ing the p r o t e s t s of t h e r e s i s t a n t infant. Unresolved individuals
give indications of significant disorganization in their a t t a c h -
ment-relationship r e p r e s e n t a t i o n in s e m a n t i c or syntactic con-
fusions in their n a r r a t i v e s concerning childhood t r a u m a or a
recent loss.
40 / Theoretical Perspectives

Major longitudinal s t u d i e s (C. Hamilton 1994; M. Main 1997;

Waters, Merrick, Albersheim, Treboux, a n d Crowell" 1995) have
s h o w n a 6 8 - 7 5 % c o r r e s p o n d e n c e with a t t a c h m e n t classifica-
tions in infancy a n d classifications in adulthood. This is a n
unparalleled level of consistency between behavior observed in
infancy a n d o u t c o m e s in a d u l t h o o d , although, obviously, s u c h
behavior m a y well be m a i n t a i n e d by c o n s i s t e n t e n v i r o n m e n t s a s
well a s by p a t t e r n s laid down in t h e first year of life. Moreover,
a t t a c h m e n t relationships play a key role in t h e t r a n s g e n e r a t i o n a l
t r a n s m i s s i o n of deprivation. S e c u r e a d u l t s a r e t h r e e or four
times m o r e likely to have children w h o are securely a t t a c h e d to
t h e m (van IJzendoorn 1995). This is t r u e even w h e r e p a r e n t a l
a t t a c h m e n t is a s s e s s e d before t h e b i r t h of t h e child (Steele,
Steele, a n d Fonagy 1996; Ward a n d C a r l s o n 1995). Parental
a t t a c h m e n t p a t t e r n s predict v a r i a n c e in addition to tempera-
m e n t m e a s u r e s or contextual factors, s u c h a s life events, social
s u p p o r t , a n d psychopathology (Steele, 1991).
T h e a t t a c h m e n t s y s t e m (Bowlby 1969, 1973, 1980) is inti-
mately c o n n e c t e d w i t h t h e p r o c e s s of r e p r e s e n t a t i o n a l m a p p i n g
a n d t h e development of t h e reflective function of t h e self. There
is general a g r e e m e n t that, a s t h e self exists only in t h e context
of t h e other, t h e development of t h e self is t a n t a m o u n t to the
aggregation of experiences of self in relationships (e.g.,
Crittenden 1994; Sroufe 1990). Psychoanalytic object relations
(Kernberg 1982; Winnicott 1965) a n d a t t a c h m e n t (Bowlby 1980)
t h e o r i s t s a r e in a g r e e m e n t t h a t repeated, invariant a s p e c t s of
self-other relations a r e a b s t r a c t e d into i n t e r n a l r e p r e s e n t a t i o n a l
m e n t a l models (Johnson-Laird 1983) a n d s t r u c t u r e d , to u s e
Kernberg's term, into self-other-affect t r i a d s or i n t e r n a l working
models, according to Bowlby. Although in its original formulation
t h e concept of internal working model lacked specificity (Dunn
1996), m o r e r e c e n t empirical work by psychoanalytic clinicians
h a s greatly improved t h e specificity of t h i s c o n s t r u c t (Horowitz
1995; Luborsky a n d Luborsky 1995).
At t h e s a m e time, cognitive scientists have elaborated the
notion of p r o c e d u r a l m e m o r i e s b a s e d on t h e n o n c o n s c i o u s
implicit u s e of p a s t experience ( J o h n s o n a n d M u l t h a u p 1992;
Kihlstrom a n d Hoyt 1990; Pillemer a n d White 1989; S c h a c h t e r
1992; Squire 1987; Tobias, Kihlstrom, a n d S c h a c h t e r 1992).
 Attachment and Reflective Function / 41

There is general a g r e e m e n t t h a t t h e m e m o r y s y s t e m is a t least of

a d u a l n a t u r e with two relatively i n d e p e n d e n t , neurologically
and psychologically h o m o g e n e o u s s y s t e m s u n d e r p i n n i n g it. In
addition to t h e autobiographical memory, which is a t least
in p a r t accessible to a w a r e n e s s , a n i m p o r t a n t additional com-
ponent to m e m o r y is a n o n v o l u n t a r y s y s t e m t h a t is implicit,
principally perceptual, nondeclarative, a n d nonreflective (D. L.
S c h a c h t e r 1992; Squire 1987). It is possible t h a t it is, a t least in
certain respects, m o r e d o m i n a t e d by emotional a n d impression-
istic information t h a n its autobiographical c o u n t e r p a r t (Pillemer
a n d White 1989; Tobias et al. 1992; v a n der Kolk 1994). It stores
the "how" of executing s e q u e n c e s of actions, motor skills being
prototypical i n s t a n c e s . The p r o c e d u r a l knowledge t h a t it con-
tains is accessible only t h r o u g h performance. It manifests itself
only w h e n t h e individual engages in t h e skills a n d operations
into w h i c h knowledge is e m b e d d e d . Given t h e s e features, it
seems likely thatSthe s c h e m a t i c r e p r e s e n t a t i o n s postulated by
a t t a c h m e n t a n d object-relations t h e o r i s t s a r e m o s t usefully con-
s t r u e d a s p r o c e d u r a l memories, t h e function of w h i c h is to a d a p t
social behavior to specific interpersonal contexts.
The classification of p a t t e r n s of a t t a c h m e n t in infancy
(Ainsworth et al. 1978) t a p s into p r o c e d u r a l m e m o r y (Crittenden
1990; Fonagy 1995a). The s t r e n g t h o f t h e S t r a n g e Situation a s a
method of psychological a s s e s s m e n t is t h a t it provides a power-
ful a n a l o g u e of p a s t situational contexts within w h i c h knowledge
concerning t h e "how" of behavior with a specific caregiver is
accrued. In t h i s s e n s e a t t a c h m e n t is a skill, one t h a t is acquired
in relation to a specific caregiver a n d encoded into a teleological
model of behavior. In t h e London P a r e n t - C h i l d S t u d y we investi-
gated t h e q u e s t i o n of h o w well t h e Adult A t t a c h m e n t Interview,
administered before t h e b i r t h of t h e first child to 100 predomi-
nantly middle-class p r i m i p a r o u s p a r e n t s , could predict t h e clas-
sification of t h e infant's a t t a c h m e n t a t t h e age of 12 m o n t h s to
mother a n d a t 18 m o n t h s to father (Fonagy, Steele, a n d Steele
1991). There w a s only a marginally significant association be-
tween t h e a t t a c h m e n t classification with m o t h e r a n d t h a t with
father. However, b o t h t e s t r e s u l t s were powerfully predicted by
the a t t a c h m e n t classification of t h e respective p a r e n t on t h e AAI
(Steele et al. 1996). T h e small overlap between t h e two s e t s of
42 / Theoretical Perspectives

classifications could be equally well a c c o u n t e d for by a s s u m i n g a

t e m p e r a m e n t factor or by t h e generalization of t h e child's
behavior with t h e m o t h e r (reflecting h e r a t t a c h m e n t classifica-
tion) on h i s behavior with t h e father. T h e r e s u l t s suggest t h a t
t h e infant develops i n d e p e n d e n t models (self-other s c h e m a t a ) for
its major a t t a c h m e n t relations b a s e d on its p a s t history of inter-
actions with e a c h of t h o s e individuals. T h e s e interaction experi-
e n c e s are, in t u r n , indexed^ by t h e caregiver's r e p r e s e n t a t i o n of
their a t t a c h m e n t history.
There h a s b e e n considerable r e s e a r c h on t h e m a n n e r in which
r e p r e s e n t a t i o n s of a t t a c h m e n t might influence t h e caregiver's
behavior with t h e child. Van U z e n d o o r n ' s (1995) comprehensive
review identifies a "transmission gap," to t h e extent t h a t t h e
variability t h a t AAI n a r r a t i v e s a n d S S n classifications s h a r e
is n o t a c c o u n t e d for by observational d a t a concerning the
sensitivity of caregiver behavior. Indeed, s t u d i e s o f t h e AAI-SSn
association, w h i c h c o n c u r r e n t l y m e a s u r e d t h e sensitivity of
caregiver-infant interaction; h a v e yielded negative (Ward a n d
Carlson 1995) or inconclusive (van U z e n d o o r n , Kranenburg,
Zwart-Woudstra, V a n B u s s c h b a c h , a n d L a m b e r m o n 1991) re-
s u l t s . Previously, we h a v e suggested t h a t t h e t r a n s m i s s i o n g a p
m a y be a c o n s e q u e n c e of t h e limitations of m e a s u r e s of sensitiv-
ity (Fonagy, Steele, Moran, Steele, a n d Higgitt 1992; Fonagy,
Steele, et al. 1995). Sensitivity is a generic c o n s t r u c t covering a
wide r a n g e of p a r e n t a l behaviors (Belsky, Rosenberger, a n d
C m i c 1995). Not all of t h e s e m a y be equally relevant in engender-
ing s e c u r e a t t a c h m e n t . If s e c u r e a t t a c h m e n t is conceived of a s
t h e acquisition of p r o c e d u r e s of goal-oriented rational action for
t h e regulation of aversive s t a t e s of a r o u s a l within a n a t t a c h m e n t
context (Carlson a n d Sroufe 1995; Cassidy 1994; Sroufe 1996),
we a r g u e t h a t t h e s e would b e m o s t consistently acquired a n d
coherently r e p r e s e n t e d w h e n t h e child's a c u t e affective state is
accurately, b u t n o t overwhelmingly, reflected b a c k to t h e child.
The child who looks for a w a y of m a n a g i n g h i s d i s t r e s s finds
in • t h e r e s p o n s e of t h e caregiver a r e p r e s e n t a t i o n of h i s m e n t a l
state t h a t h e m a y internalize a n d u s e a s p a r t of a higher-order
strategy of affect regulation. T h e s e c u r e caregiver s o o t h e s by
combining mirroring with a display t h a t is incompatible with t h e
 Attachment and Reflective Function / 43

child's affect ( t h u s p e r h a p s implying coping). This formulation of

sensitivity h a s m u c h in c o m m o n with t h e notion of British
psychoanalyst Wilfred Bion (1962a), of t h e role of t h e m o t h e r ' s
capacity to mentally "contain" t h e affect state t h a t feels intoler-
able to t h e b a b y a n d r e s p o n d in t e r m s of physical care in a
m a n n e r t h a t acknowledges t h e child's m e n t a l state, yet serves to
modulate u n m a n a g e a b l e feelings. The finding t h a t t h e clarity
and coherence of t h e m o t h e r ' s r e p r e s e n t a t i o n of t h e child medi-
ates between t h e AAI a n d m o t h e r ' s observed behavior is certainly
consistent with t h i s model (Slade, Belsky, Aber, a n d Phelps
1999). Ratings of t h e quality of t h e reflective function of e a c h
caregiver were found i n d e p e n d e n t l y to predict t h e child's secu-
rity of a t t a c h m e n t in t h e London Parent-Child S t u d y (Fonagy,
Steele, Moran, Steele, a n d Higgitt 1991).
If s e c u r e a t t a c h m e n t is t h e o u t c o m e of successful contain-
ment, i n s e c u r e a t t a c h m e n t m a y be seen a s t h e infant's identifi-
cation with t h e caregiver's defensive behavior. Proximity to t h e
caregiver is m a i n t a i n e d a t t h e cost of reflective function. A dis-
missing (Ds) caregiver m a y altogether fail to mirror t h e child's
distress b e c a u s e of t h e painful experiences this evokes for her or
because s h e lacks t h e capacity to create a c o h e r e n t image of t h e
child's m e n t a l s t a t e . In c o n t r a s t , t h e preoccupied (E) caregiver
may r e p r e s e n t t h e infant's s t a t e with excessive clarity or in a way
that is complicated by r e s p o n s e s to t h e p a r e n t ' s ambivalent
preoccupation with h e r own experience, so m u c h so t h a t t h e
symbolic potential of t h e exchange is lost. In b o t h c a s e s t h e
infant internalizes t h e caregiver's attitude a n d "this dysynchrony
becomes t h e c o n t e n t of t h e experience of t h e s e l f (Crittenden
1994, p. 89).
We m a y s p e c u l a t e a s to t h e i m p a c t of s u c h a state of affairs
on the development of t h e child's s e n s e of self. We k n o w t h a t
avoidant infants r e s p o n d to s e p a r a t i o n with minimal displays of
distress while experiencing considerable physiological a r o u s a l
(Spangler a n d G r o s s m a n n 1993). Crittenden (1988; Crittenden
and DiLalla 1988) r e p o r t s t h a t 1-year-old maltreated children
display falsely positive affect t h a t does n o t m a t c h their t r u e
feelings. At a n extreme, t h e internalization of t h e caregiver's
defenses c a n lead n o t only to a failure to r e p r e s e n t a n d display
44 / Theoretical Perspectives

a c t u a l emotional experience adequately, b u t also to t h e con-

struction- of a n experience of self a r o u n d t h i s false internaliza-
tion (Winnicott 1965).
While t h e c o n s c i o u s experience of "putting on a n act" m a y be
a fairly general experience, particularly in adolescence (Harter,
Marold, Whitesell, a n d Cobbs 1996), in t h e c u r r e n t context we
a r e referring to t h e highly distressing experience of severe-
ly personality-disordered children w h o experience a s e n s e of
alienation from their core self (Bleiberg 1984, 1994). A strategy
adopted by m a n y s u c h children s o m e w h a t later in development
is to a t t e m p t to externalize this false p a r t of their self-represen-
tation a n d m a n i p u l a t e t h e behaviors of o t h e r s a r o u n d t h e m so
t h a t t h e s e m a t c h t h e i n c o n g r u e n t self-representation. We would
a r g u e t h a t t h i s model explains t h e strangely coercive behavior
with t h e caregiver of preschool children w h o s e a t t a c h m e n t a t t h e
stage of infancy w a s classified a s disorganized (Cassidy, Marvin,
a n d T h e MacArthur Working G r o u p on A t t a c h m e n t 1989; Crit-
t e n d e n 1992; Main a n d Cassidy 1988). T h e s e children—and
adults—become quite skilled a n d sensitive in m a n i p u l a t i n g oth-
e r s to get t h e m to b e h a v e consistently with their internal repre-
s e n t a t i o n s . T h e s e a r e n o t their r e p r e s e n t a t i o n s of self-other
relationships, w h i c h we all try to actualize. In a far m o r e desper-
ate way t h e s e children a n d a d u l t s try to provoke behavior con-
s i s t e n t with a p a r t of t h e self-representation experienced a s
"alien," which they feel forced to externalize in order to achieve a
more coherent perception of t h e r e s i d u a l self (Fonagy a n d Target
1995).

A T T A C H M E N T S E C U R I T Y IN T H E C H I L D
A N D REFLECTIVE FUNCTION

There is general a g r e e m e n t t h a t t h e " h a r m o n i o u s n e s s of the

mother-child' relationship c o n t r i b u t e s to t h e emergence of
symbolic t h o u g h t " (Bretherton, Bates, Benigni, Camaioni, a n d
Volterra 1979, p. 224), a n d t h e idea h a s a long a n d distin-
guished history (Mahler, Pine, a n d B e r g m a n 1975; Vygotsky
1978; Werner a n d Kaplan 1963). Bowlby (1969) recognized the
 Attachment and Reflective Function / 45

significance of t h e developmental step entailed in t h e emergence

of "the child's capacity b o t h to conceive of h i s m o t h e r a s having
her own goals a n d ' i n t e r e s t s s e p a r a t e from h i s own a n d to t a k e
t h e m into a c c o u n t " (1969, p. 368). Moss, Parent, a n d Gosselin
(1995) reported t h a t a t t a c h m e n t security with m o t h e r w a s a
good c o n c u r r e n t predictor of metacognitive capacity in t h e child
in t h e d o m a i n s of memory, c o m p r e h e n s i o n , a n d c o m m u n i c a t i o n .
The S e p a r a t i o n Anxiety Test, a projective t e s t of a t t a c h m e n t
security, h a s b e e n s h o w n to be a good predictor of belief-desire
reasoning capacity in 3V4- to 6-year-old children w h e n age,
verbal m e n t a l age, a n d social m a t u r i t y were all controlled for
(Fonagy, Redfern, a n d C h a r m a n 1997).
In a prospective s t u d y o f t h e relationship of a t t a c h m e n t secu-
rity to m o t h e r (12 m o n t h s ) a n d to father (18 m o n t h s ) a n d per-
formance on t h r e e t e s t s of theory of mind a t 5V4 y e a r s (Fonagy
1997), 9 2 of 9 6 children tested in t h e S t r a n g e Situation a t 12
and 18 m o n t h s were seen. Of t h o s e classified a s s e c u r e a t 12
m o n t h s with m o t h e r , 8 2 % p a s s e d t h e belief-desire reasoning
task, in w h i c h t h e child is challenged to predict w h a t a c h a r a c t e r
would feel, b a s e d on h i s or h e r knowledge of t h e c h a r a c t e r ' s
belief. (If Ellie t h i n k s t h e c a n h a s coke in it, a n d likes coke, will
she w a n t t h e drink—even t h o u g h it is really milk?) In c o n t r a s t ,
46% of t h o s e w h o h a d b e e n classified a s Insecure failed. Infant-
father a t t a c h m e n t (at 18 m o n t h s ) also predicted t h e child's per-
formance, with 77% of infants classified a s s e c u r e p a s s i n g t h e
test, compared to 5 5 % of children classified a s insecure. There
was some indication of a n additive relationship, in t h a t 8 7 % of
children with two s e c u r e relationships p a s s e d t h e belief-desire
task, a n d 6 3 % of t h o s e with only one s e c u r e relationship a n d
only 50% of t h o s e I n s e c u r e with b o t h did so. A similar b u t
somewhat w e a k e r p a t t e r n could be observed with t h e second-
order false-belief t a s k , w h i c h r e q u i r e s t h e child to r e a s o n on t h e
basis of w h a t one c h a r a c t e r k n o w s a b o u t a n o t h e r c h a r a c t e r ' s
wrong belief. Of t h o s e s e c u r e with b o t h p a r e n t s , 36% p a s s e d ,
compared with 2 3 % w h o were s e c u r e with one a n d 9% w h o were
insecure with b o t h .
In a s o m e w h a t smaller b u t nevertheless careful longitudinal
study of m o t h e r - i n f a n t dyads, Meins a n d colleagues (Meins,
Fernyhough, Russel, a n d Clark-Carter 1998) reported t h a t 8 3 %
46 / Theoretical Perspectives

of children who were securely a t t a c h e d in infancy p a s s e d a false-

belief t a s k a t t h e age of 4, in c o m p a r i s o n with 3 3 % of insecurely
a t t a c h e d peers. At age 5, 85% of securely a t t a c h e d children a n d
50% of insecurely a t t a c h e d o n e s p a s s e d a t a s k requiring a n
u n d e r s t a n d i n g of information access. Although t h e s t u d y w a s
n o t .able to replicate o u r r e s u l t s on t h e false-belief a n d emotion
t a s k (probably b e c a u s e of its small sample), t h e general trend of
t h e findings confirms t h a t security of a t t a c h m e n t is significantly
linked to symbolic abilities in general a n d to precocious m e n -
talizing in particular.
Both trivial a n d s u b s t a n t i v e explanations could b e offered to
a c c o u n t for t h e s e findings. They would be trivial if t h e association
of s e c u r e a t t a c h m e n t a n d false-belief u n d e r s t a n d i n g were d u e to
a n a s yet u n k n o w n a n d u n m e a s u r e d third factor, s u c h a s tem-
p e r a m e n t . More plausibly, it could be a r g u e d t h a t t h e facilitative
effect of s e c u r e a t t a c h m e n t is d u e to a m o r e relaxed, t a s k -
oriented attitude, to a general facility to engage in a cognitively
d e m a n d i n g task, or to a n ability to relate to a n a d u l t experi-
m e n t e r in a playful, exploratory way. All t h e s e explanations
reflect child performance r a t h e r t h a n competence. This sugges-
tion could be tested u s i n g a false-belief t a s k w h e r e implicit a n d
explicit knowledge of false belief is separately a s s e s s e d (Clements
a n d Perner 1994). If a t t a c h m e n t security relates to performance,
t h e n securely a t t a c h e d children would be expected to do better
only on t h e explicit (verbal/pointing) t a s k . Implicit, p r o c e d u r a l
false-belief r e a s o n i n g would b e expected to be facilitated by
s e c u r e a t t a c h m e n t only if t h i s w a s associated with superior
reflective capacity. This r e m a i n s to b e s t u d i e d . In w h a t follows,
we shall cautiously a s s u m e t h a t t h e relationship between false-
belief r e a s o n i n g a n d security of a t t a c h m e n t is nontrivial.
There a r e two alternative explanations for this relationship:
(a) One class of models would suggest t h a t security of a t t a c h -
m e n t in infancy p r e d i s p o s e s children to benefit from certain
social p r o c e s s e s t h a t m a y be directly involved in t h e development
of reflective abilities a n d social u n d e r s t a n d i n g , (b) T h e second
class of models would suggest t h a t security of a t t a c h m e n t is a n
indicator of t h a t quality of infant-caregiver relationship which
generates psychological u n d e r s t a n d i n g . In t h i s second model t h e
 Attachment and Reflective Function / 47

social p r o c e s s e s t h a t accelerate t h e mentalizing quality of self-

organization a r e t h e very s a m e a s t h o s e t h a t e n s u r e security of
attachment.
Mediatlonal models would require t h a t two conditions be
satisfied: (a) compelling evidence t h a t a specific set of social
processes is involved in t h i s a s p e c t of t h e development of self-
organization, a n d (b) t h a t s u c h social p r o c e s s e s a r e e n h a n c e d in
securely a t t a c h e d individuals. At least t h r e e c a n d i d a t e s meet
these criteria.

1. The first is pretense. There is evidence t h a t children in their

thtrd year w h o engage m o r e readily in cooperative interaction
(Dunn et al. 1991), a n d specifically in joint p r e t e n d play (Asting-
ton a n d J e n k i n s 1995; Taylor, Gerdw, a n d Carlson 1993; Young-
blade a n d D u n n 1995), s h o w superior m i n d - r e a d i n g a n d emotion
u n d e r s t a n d i n g performance. A s e p a r a t e body of observations
from longitudinal s t u d i e s of a t t a c h m e n t indicates t h a t preschool
children w h o were securely a t t a c h e d to their m o t h e r in infancy
manifest s t r o n g e r e n g a g e m e n t in fantasy play t h a n do avoidant
children, w h o s e level of e n g a g e m e n t is low a n d w h o s e p r e t e n d
play is impoverished (Rosenberg, cited in Carlson a n d Sroufe
1995; Main, Kaplan, a n d Cassidy 1985). Children rated a s
securely a t t a c h e d to their m o t h e r s d u r i n g infancy h a v e b e e n
reported to engage in more frequent a n d sophisticated solo
pretense, (Belsky, G a r d u q u e , a n d Hrncir 1984; B r e t h e r t o n et al.
1979; Matas, Arend, a n d Sroufe 1978). Slade (1987) found t h a t
m a t e r n a l involvement in 3-year-olds' play served a facilitating
function only for securely a t t a c h e d children. Meins a n d col-
leagues (Meins et al. 1998).demonstrated t h a t children w h o were
classified a s securely a t t a c h e d in infancy were better able to
incorporate t h e p r e t e n s e suggestions of a n experimenter in their
play a t 31 m o n t h s .
It is probable t h a t joint p r e t e n d play or playfulness fosters t h e
u n d e r s t a n d i n g of m e n t a l s t a t e s . Deliberate role-taking is seen a s
being integral to t h e "off-line simulation" model of t h e perform-
ance of m i n d r r e a d i n g t a s k s (Currie 1995; G o l d m a n 1989). Within
other models, p r e t e n d play is a n early manifestation of t h e
theory-of-mind m e c h a n i s m s (Leslie 1987). T h e question of why
48 / Theoretical Perspectives

3-year-olds c a n u n d e r s t a n d t h a t s o m e o n e is e n t e r t a i n i n g a pre-
tend representation b u t n o t a false belief (Harris a n d K a v a n a u g h
1993; Harris, Kavanaugh, a n d Meredith 1994), a p r e t e n d / r e a l
distinction b u t n o t a n a p p e a r a n c e / r e a l i t y one (Flavell, Flavell,
a n d Green 1987) is a n i m p o r t a n t puzzle. In t h e case of pretend,
t h e r e p r e s e n t a t i o n s , while t h e y a r e different from reality, are
s h a r e d by t h o s e engaged in t h e pretend game. As Astington p u t
it: "they are intermental, n o t intramental" (1996, p. 193). The
s h a r i n g of r e p r e s e n t a t i o n s t h a t are different from reality may
help in u n d e r s t a n d i n g s i t u a t i o n s where r e p r e s e n t a t i o n s are n o t
only" different from reality b u t a r e n o t s h a r e d in a social pretend
d o m a i n . In joint p r e t e n d play or playfulness t h e a d u l t a d o p t s t h e
child's m e n t a l s t a n c e a n d r e - p r e s e n t s it to t h e child in relation to
a third object, w h i c h is symbolically held in m i n d by both.
Pretending requires a m e n t a l s t a n c e involving t h e symbolic
transformation of reality in t h e p r e s e n c e of, a n d with a view to,
t h e m i n d of t h e other. T h e adult, o r p e r h a p s t h e older sibling,
holds t h e frame of external reality while accurately r e p r e s e n t i n g
t h e child's m e n t a l state. T h e scaffolding provided by t h e child's
playmate in p r e t e n d play (Vygotsky 1967) n o t only p r o m o t e s
earlier s u c c e s s b u t is t h e m e c h a n i s m w h e r e b y t h e development
of reflection comes a b o u t . Lillard (1993) a r g u e d t h a t symbolic
play m a y offer a "zone of proximal development" for t h e skills
t h a t s u b s e r v e m i n d - r e a d i n g ability. Children with a s e c u r e at-
t a c h m e n t history m a y b e m o r e likely.to engage in a n activity t h a t
p r e s u m e s a degree of t r u s t , insofar a s t h e child relies o n t h e
other's version or perception of reality.

2. The second is talking. There is evidence t h a t conversations

a b o u t feelings a n d t h e r e a s o n s b e h i n d people's actions a r e linked
to t h e relatively early achievement of reflective function (Brown,
Donelan-McCall, a n d D u n n 1996; D u n n a n d Brown 1993).
Mothers who s p o n t a n e o u s l y explained their emotions to 3V£-
year-olds d u r i n g laboratory simulation were s h o w n to have chil-
d r e n with e n h a n c e d emotion u n d e r s t a n d i n g over t h e s u b s e q u e n t
15-month period ( D e n h a m et al. 1994). Conversational opportu-
nities concerning m e n t a l s t a t e s a p p e a r to improve children's
mentalizing performance in experimental s t u d i e s (Appleton a n d
Reddy 1996).

a
 Attachment and Reflective Function / 49

Strage a n d Main (cited in Carlson a n d Sroufe 1995) reported

t h a t discourse p a t t e r n s between m o t h e r s a n d children a t age 6
could b e predicted from early a t t a c h m e n t classification. S e c u r e
dyads were m o r e fluent a n d able to d i s c u s s a wider r a n g e of
topics t h a n t h o s e classified a s avoidant, w h o showed little topic
elaboration. P a t t e r n s of m o t h e r - c h i l d interaction characteristic
of secure d y a d s — s h a r e d play, comforting, or joking—also define
the contexts within w h i c h t h e m o t h e r ' s explanations of m e n t a l
states are found to be particularly facilitative of reflective func-
tion (Dunn 1996). S e c u r e children find it easier to deal with
emotional i s s u e s in a n open a n d free w a y (Bretherton, Ridgeway,
and Cassidy 1990; Cassidy 1988). Mother-child verbal interac-
tions associated with t h e early acquisition of reflective capacity
predominantly c o n c e r n emotionally charged m a t t e r s ( D u n n
1996). S e c u r e a t t a c h m e n t m a y t h e n e n g e n d e r p a t t e r n s of verbal
interaction b e t w e e n child a n d caregiver, w h i c h in t u r n s u p p o r t
thinking a b o u t feelings a n d intentions.
P. K. S m i t h (1996) forcefully a d v a n c e d t h e central role of
language in t h e acquisition of mentalizing capacity. Using pri-
mate evidence, h e suggested t h a t t h e availability of symbolic
codes (words) for m e n t a l s t a t e s w a s crucial for t h e developing
individual to acquire m i n d - r e a d i n g abilities, a n d t h e explicit u s e
of s u c h codes by caregivers w a s therefore likely to be important.
Even more p e r t i n e n t in t h i s context is Harris's (1996) proposal
t h a t t h e experience of engaging in conversations per se alerts
children to t h e fact t h a t people a r e receivers a n d providers of
information, irrespective of w h e t h e r t h a t conversation involves
reference to m e n t a l s t a t e s (knowing, thinking, desiring, etc.). T h e
s t r u c t u r e of information-bearing conversations (e.g., being told
about a p a s t event t h a t one h a s n o t witnessed, challenging of
information in d i s s e n t a n d denial, or filling in information g a p s
in questions or w h e n information exchange misfires a n d repair is
needed) strongly implies t h a t p a r t n e r s in a conversation differ in
what they k n o w a n d believe a b o u t a s h a r e d topic. Effective
conversation r e q u i r e s t h a t g a p s in s h a r e d knowledge a n d belief
are acknowledged a n d a d d r e s s e d . The m e a s u r e m e n t of a t t a c h -
ment in a d u l t s (Main a n d Goldwyn 1994) strongly e n d o r s e s t h e
suggestion t h a t s e c u r e a t t a c h m e n t is associated with greater
sensitivity to t h e r u l e s of conversation a s defined by Grice (1975).
50 / Theoretical Perspectives

3. T h e third potential mediator is peer group interaction. We

have already noted t h a t t h e possibility of interaction with sib-
lings is likely to e n h a n c e theory-of-mind performance ( J e n k i n s
a n d Astington 1996; Perner et al. 1994; Ruffman et al. 1998).
Importantly, t h e child's u s e of m e n t a l - s t a t e t e r m s with siblings
or friends is a b e t t e r predictor of performance on false-belief
t a s k s t h a n is mother-child conversation (Brown et al. 1996).
Likewise, Lewis a n d colleagues (Lewis, F r e e m a n , Kyriakidou,
Maridaki-Kassotaki, a n d Berridge 1996) d e m o n s t r a t e d t h a t
false-belief u n d e r s t a n d i n g w a s related to t h e a m o u n t of time t h a t
children s p e n t with older siblings, older friends, a n d older kin,
b u t n o t with y o u n g e r p e r s o n s . There is a n i n d e p e n d e n t body of
evidence t h a t s u p p o r t s a s t r o n g link between s e c u r e a t t a c h m e n t
in infancy a n d ratings of peer competence (Elicker, E n g l u n d , a n d
Sroufe 1992). Children with s e c u r e a t t a c h m e n t histories are
consistently observed a n d r a t e d more socially oriented, capable
of reciprocity, popular, a n d e m p a t h i c t h a n t h o s e with i n s e c u r e
histories (Lieberman 1977; P a n c a k e 1985; P a r k a n d W a t e r s
1989; Sroufe 1983).
Both simulation theory a n d t h e o r y - t h e o r y e x p l a n a t i o n s of the
development of m i h d - r e a d i n g offer good explanations o f t h e facil-
itative effect of m o r e i n t e n s e peer-group interaction (Ruffman et
al. 1998). Peer-group interaction should increase t h e opportuni-
ties t h a t children h a v e for simulation, imagining w h a t they
would see, think, feel, a n d so on if t h e y were in a n o t h e r person's
situation. Equally, interaction with p e e r s or older siblings could
be s e e n from a theory-theory perspective a s a rich s o u r c e of
ideas a b o u t how t h e m i n d works. An alternative view m a y be t h a t
e n c u l t u r a t i o n is itself t h e source of t h e child's m e n t a l - s t a t e
concepts (Astington 1996). B r u n e r (1983) proposed t h a t p a r e n t s '
t e n d e n c y to t r e a t t h e infant's s p o n t a n e o u s g e s t u r e s as if they
were intentional c o m m u n i c a t i o n s leads to infants seeing
themselves a s having i n t e n t i o n s a n d s t a r t i n g to c o m m u n i c a t e
intentionally. T h e social world—in t h e first i n s t a n c e , t h e par-
ent—fosters t h e child's s e n s e of h i s m e n t a l self t h r o u g h complex
linguistic a n d interactional processes, b e h a v i n g toward t h e in-
fant in a way t h a t leads h i m eventually to s h a r e t h e a s s u m p t i o n
t h a t h i s own behavior a n d (by simulation or t h e observation of
 Attachment and Reflective Function / 51

similar i n t e r a c t i o n s between t h e caregiver a n d others) t h a t

of others m a y b e b e s t u n d e r s t o o d in t e r m s of m e n t a l s t a t e s .
T h r o u g h participation in activities of their c u l t u r e t h e y c o m e t o
s h a r e their c u l t u r e ' s way of regarding others' a n d their own
actions. If children's e n t r y into t h e folk psychology is viewed a s a
process of "apprenticeship" in w h i c h senior peers a n d caregivers
are seen a s e n c o u r a g i n g t h e child's adoption of mentalizing
concepts (Astington 1996; Lewis et al. 1996), t h e n s e c u r e attache
m e n t m a y b e considered a s a k i n d of catalyst to t h i s l e a r n i n g
process. The g r e a t e r r e a d i n e s s with w h i c h s e c u r e children a r e
willing to explore a n d engage with t h e social world could t h e n
account for their relative c o m p e t e n c e in mentalizing abilities.

There is n o t h i n g m u t u a l l y exclusive a b o u t t h e s e t h r e e rnedia-

tional models. P r e t e n s e often involves t h e u s e of m e n t a l - s t a t e
language. Interaction with p e e r s often involves b o t h l a n g u a g e
and pretense. In general, t h e s e mediational models suggest t h a t
propensity for social e n g a g e m e n t a c r o s s a n u m b e r of contexts
e n h a n c e s t h e development of social u n d e r s t a n d i n g a n d t h a t
s u c h social e n g a g e m e n t is m o r e readily accessible in t h e families
of securely a t t a c h e d y o u n g children. However, t h e r e is a major
problem with s u c h a singular model. Evidence from D u n n ' s work
suggests t h a t t h e s e different contexts correlate poorly with one
another (Dunn 1996). For example, observational d a t a indicate
t h a t individual differences found in pretend play, m a n a g e m e n t of
conflict, a n d d i s c o u r s e a b o u t m e n t a l s t a t e s are n o t correlated
among social s i t u a t i o n s (mothers, siblings, close friend), al-
t h o u g h e a c h correlates with socio-cognitive a s s e s s m e n t s (Brown
et al. 1996; Slomkowski a n d D u n n 1992; Youngblade a n d D u n n
1995). T h e fact t h a t children's behavior correlates poorly a c r o s s
social p a r t n e r s a n d s i t u a t i o n s , a l t h o u g h e a c h of t h o s e s i t u a t i o n s
relates to t e s t performance, could suggest t h a t t h e r e a r e several
independent, s i m u l t a n e o u s l y operating p a t h w a y s between at-
t a c h m e n t a n d social s i t u a t i o n s .
Alternatively, it is possible t h a t t h e variables t h a t prima facie
may be considered to b e mediating t h e a t t a c h m e n t / m i n d - r e a d -
ing relationship a r e n o t on t h e c a u s a l p a t h a t all, t h a t their
correlation with t h e r a t e of acquisition of m i n d - r e a d i n g is spuri-
52 / Theoretical Perspectives

ous, a n d t h a t t h e c a u s a l s e q u e n c e of t h e relationship d o e s n o t
involve t h e s e social experiences b u t is directly related to the
child's a t t a c h m e n t s t a t u s . T h e early experience with t h e care-
givers in t h e first year of life m a y create t h e bedrock of theory-of-
m i n d competence, e n s u r i n g t h e child's move from a teleological
to a mentalizing model of behavior. W h a t evidence do we have to
s u p p o r t s u c h a c o n t e n t i o n ? First, it is i m p o r t a n t to n o t e t h a t in
t h e London d a t a , a m o t h e r ' s a t t a c h m e n t classification before the
birth of t h e child w a s a powerful predictor of t h e child's theory-
of-mind c o m p e t e n c e a t 5 years; 75% of children of secure, a u -
t o n o m o u s m o t h e r s p a s s e d t h e cognitive-emotion t a s k , w h e r e a s
only 16% of children of preoccupied m o t h e r s a n d 25% of t h o s e of
unresolved m o t h e r s did so (Fonagy 1997). Although on t h e face
of it this could be a c c o u n t e d for by t h e models already discussed,
we believe t h a t t h e r e is now evidence t h a t t h e caregiver brings
s o m e t h i n g to t h e p a r e n t - c h i l d relationship, evident even before
t h e birth'of t h e child, w h i c h m a y b e critical in t h e child's estab-
l i s h m e n t of b o t h s e c u r e a t t a c h m e n t a n d mind-reading.
W h a t might t h i s b e ? It is well established t h a t , in infancy,
m o t h e r s of securely a t t a c h e d children a r e m o r e sensitive to their
children's n e e d s (Ainsworth, Bell, a n d S t a y t o n 1971; Isabella
1993). We have already t o u c h e d on t h e fact t h a t t h e caregiver's
capacity to envision t h e m e n t a l s t a t e s of h e r own p a r e n t s is
predictive of t h e infant's security of a t t a c h m e n t to e a c h of his
caregivers (Fonagy, Steele, Moran, et al. 1991). In t h e London
project, m o t h e r s w h o were more likely to invoke m e n t a l s t a t e s in
their a c c o u n t s of their childhood a t t a c h m e n t experiences h a d
children with superior m i n d - r e a d i n g abilities (controlling for ver-
bal fluency in t h e child). Ratings on t h e RF scale were found to
predict t h e child's performance on cognitive-emotion t a s k s also
for fathers. Even m o r e important, a p a t h a n a l y s i s revealed t h a t a
m o t h e r ' s capacity to reflect on h e r own childhood in t h e AAI
s h a r e d t h a t portion of t h e variance with t h e child's theory-of-
m i n d performance t h a t w a s predicted by t h e quality of m o t h e r -
infant a t t a c h m e n t . In a more complex p a t h analysis, we found
t h a t t h e m o t h e r ' s mentalizing ability h a d a direct a s well a s
indirect relationship with t h e child's theory of m i n d . T h u s , the
child's a t t a c h m e n t security w a s n o t t h e only predictor. The
 Attachment and Reflective Function / 53

m o t h e r ' s c a p a c i t y to envision t h e child a s a m e n t a l entity also

seemed to b e i m p o r t a n t .
S u c h d a t a suggest t h a t c o m m o n m e c h a n i s m s u n d e r p i n at-
t a c h m e n t organization in t h e caregiver a n d t h e infant a n d t h e
precocious e m e r g e n c e of mentalizing. It should be r e m e m b e r e d
t h a t n o unequivocal c a u s a l p a t h s were identified a m o n g medi-
ational models. T h e relative i m p o r t a n c e of v a r i o u s potential
mediational m e c h a n i s m s for t h e a t t a c h m e n t - t h e o r y - o f - m i n d re-
lationship varies according to context, b u t intergenerational d a t a
may be c o n s i s t e n t with a t l e a s t two of t h e models (pretense,
language). F u r t h e r experimental r e s e a r c h t h a t m a n i p u l a t e s pa-
rental behavior a n d explores a t t a c h m e n t a n d theory-of-mind
task performance (van U z e n d o o r n , Juffer, a n d Duyvesteyn 1995)
will be n e c e s s a r y to d e t e r m i n e w h e t h e r specific behaviors t h a t
engender s e c u r e a t t a c h m e n t s i m u l t a n e o u s l y e n h a n c e mental-
izing. In order for s u c h a s t u d y to be feasible, we need a model of
how a t t a c h m e n t m a y directly relate to theory-of-mind perform-
ance. Next, therefore, we offer one model of h o w s u c h a m e c h a -
nism m a y operate.
O u r stipulation is b a s e d on t h e a s s u m p t i o n t h a t t h e acquisi-
tion of t h e theory of m i n d is p a r t of a n intersubjective p r o c e s s
between t h e infant a n d caregiver (see Gopnik 1993, for a highly
elegant elaboration of s u c h a model). In o u r view, t h e caregiver
facilitates t h e creation of mentalizing models t h r o u g h complex
linguistic a n d q u a s H i n g u i s t i c processes, primarily by behaving
toward t h e child in s u c h a way t h a t t h e child is eventually led to
postulate t h a t h i s own behavior m a y b e b e s t u n d e r s t o o d if he
a s s u m e s t h a t h e h a s i d e a s a n d beliefs, feelings a n d wishes, t h a t
determine h i s actions, a n d t h e reactions of o t h e r s to h i m c a n
t h e n be generalized to other similar beings. T h e caregiver ap-
proaches t h e crying infant with a q u e s t i o n in h e r mind: "Do you
want your n a p p y changed?" "Do you n e e d a cuddle?" T h e sensi-
tive caregiver is unlikely to a d d r e s s t h e situation without having
the p e r s o n in mind, so is unlikely to say to herself, "Are you wet
around y o u r bottom?" or ".Have you b e e n s t a n d i n g alone too
long?" T h e sensitive caregiver c a n bridge t h e focus on physical
reality a n d internally directed attention sufficiently for t h e child
to identify contingencies between i n t e r n a l a n d external expert-
54 / Theoretical Perspectives

ence. Ultimately, t h e child arrives a t t h e conclusion t h a t the

caregiver's reaction to h i m m a y be u n d e r s t o o d a s rational, given
t h e a s s u m p t i o n of a n internal s t a t e of belief or desire within
himself. Unconsciously a n d pervasively, t h e caregiver a s c r i b e s a
m e n t a l s t a t e to t h e child with h e r behavior, t r e a t i n g t h e child a s
a m e n t a l agent. This is ultimately perceived by t h e child a n d
u s e d in t h e elaboration of teleological models a n d p e r m i t s the
development of a core s e n s e of selfhood*organized along mental-
istic lines. We a s s u m e t h a t this, by a n d large, is a m u n d a n e
process, in t h e s e n s e of h a p p e n i n g every day t h r o u g h o u t early
life, a n d t h a t it is a p r o c e s s t h a t is p r e c o n s c i o u s to b o t h infant
a n d caregiver, inaccessible to reflection or modification. Care-
givers, however, execute t h i s m o s t n a t u r a l of h u m a n functions
in different ways. S o m e m a y be particularly alert to t h e earliest
indications of intentionality, while o t h e r s m a y need stronger
indications before they c a n perceive t h e child's m e n t a l s t a t e a n d
modify their behavior accordingly.
T h e child's development a n d perception of m e n t a l s t a t e s in
himself a n d o t h e r s t h u s d e p e n d s on h i s observation of t h e
m e n t a l world of h i s caregiver. He develops a concept a n d is t h u s
able to perceive m e n t a l states, to t h e extent t h a t h i s caregiver's
behavior implies s u c h s t a t e s . He does t h i s w h e n t h e caregiver is
in a s h a r e d pretend m o d e of "playing" with t h e child (hence the
association.between pretend a n d early mentalization), a n d m a n y
m o r e m u n d a n e interactions (such a s conversations a n d peer
interaction) will also involve s u c h s h a r e d m e n t a t i o n . This is w h a t
m a k e s m e n t a l - s t a t e concepts s u c h a s t h i n k i n g inherently inter-
subjective; s h a r e d experience is p a r t of t h e very logic of mental-
s t a t e concepts.
We believe t h a t t h e caregiver's capacity to observe t h e mo-
m e n t - t o - m o m e n t c h a n g e s in t h e child's m e n t a l s t a t e is critical in
t h e development of mentalizing capacity. T h e caregiver's percep-
tion of t h e child a s a n intentional being lies a t t h e root of
sensitive caregiving, which a t t a c h m e n t theorists view a s t h e
c o r n e r s t o n e of s e c u r e a t t a c h m e n t (Ainsworth et al. 1978; Bates,
Maslin, a n d F r a n k e l 1985; Belsky a n d Isabella 1988; Egeland
a n d Farber 1984; G r o s s m a n n , G r o s s m a n n , Spangler, S u e s s ,
a n d Unzner 1985; Isabella 1993; Isabella a n d Belsky 1991).
 Attachment and Reflective Function / 55

Secure a t t a c h m e n t , in its t u r n , provides t h e psychosocial b a s i s

for acquiring a n u n d e r s t a n d i n g of mind. The s e c u r e infant feels
safe in m a k i n g a t t r i b u t i o n s of m e n t a l s t a t e s to a c c o u n t for t h e
behavior of t h e caregiver. In c o n t r a s t t h e avoidant child s h u n s to
some degree t h e m e n t a l s t a t e of t h e other, while t h e r e s i s t a n t
child focuses on its own s t a t e of distress, to t h e exclusion of
close intersubjective exchanges. Disorganized infants m a y repre-
sent a special category: hypervigilant of t h e caregiver's behavior,
they u s e all c u e s available for prediction; t h e y m a y be acutely
sensitized to intentional s t a t e s a n d t h u s m a y be m o r e ready to
construct a mentalized a c c o u n t of t h e caregiver's behavior. We
would a r g u e (see below) t h a t in s u c h children mentalization m a y
be evident, b u t it does n o t h a v e t h e central role in self-organiza-
tion t h a t c h a r a c t e r i z e s securely a t t a c h e d children. We believe
t h a t w h a t is m o s t i m p o r t a n t for t h e development of mentalizing
self-organization is t h e exploration of t h e m e n t a l s t a t e of t h e
sensitive caregiver, w h i c h enables t h e child to find in t h e care-
giver's m i n d (that is, in t h e hypothetical r e p r e s e n t a t i o n of h e r
mind t h a t h e c o n s t r u c t s to explain h e r behavior toward him) a n
image of himself a s motivated by beliefs, feelings, a n d intentions.
In contrast, w h a t t h e disorganized child is s c a n n i n g for so in-
tently is n o t t h e r e p r e s e n t a t i o n of h i s own m e n t a l s t a t e s in t h e
mind of t h e other, b u t t h e m e n t a l s t a t e s of t h a t other t h a t
t h r e a t e n to u n d e r m i n e h i s own self. They c a n constitute within
the child's self-representation a n alien p r e s e n c e t h a t is so
u n b e a r a b l e t h a t h i s a t t a c h m e n t behavior b e c o m e s organized
around reexternalizing t h e s e p a r t s of t h e self onto a t t a c h m e n t
figures, r a t h e r t h a n a r o u n d t h e internalization of a capacity for
c o n t a i n m e n t of affects a n d o t h e r intentional states. There is
considerable evidence to s u p p o r t t h e view t h a t s e c u r e a t t a c h -
m e n t e n h a n c e s t h e development of t h e self, i n n e r security,
feeling of self-worth, self-reliance, a n d personal power of t h e
emerging self a s well a s t h e development of a u t o n o m y (Bates et
al. 1985; Gove 1983; Londerville a n d Main 1981; M a t a s et al.
1978). Disorganized infants, even if they acquire t h e skill of
mind-reading, fail to integrate t h i s w i t h their self-organization.
There m a y b e a n u m b e r of linked r e a s o n s for this: (a) The
child n e e d s to u s e disproportionate r e s o u r c e s to u n d e r s t a n d
56 / Theoretical Perspectives

t h e p a r e n t ' s behavior, a t t h e expense of reflecting on self-states,

(b) The caregiver of t h e disorganized infant is less likely to be
reliably contingent in r e s p o n d i n g to t h e infant's self-state a n d ,
further, to s h o w systematic b i a s e s in h e r perception a n d reflec-
tion of t h e child's state, (c) The m e n t a l s t a t e of t h e caregiver of
t h e disorganized infant evokes i n t e n s e anxiety either t h r o u g h
frightening behavior suggesting malevolence toward t h e child or
t h r o u g h behavior suggesting fear, including inexplicable fear of
t h e child himself.
These factors m a y combine to m a k e disorganized infants
become k e e n r e a d e r s of t h e caregiver's m i n d u n d e r certain cir-
c u m s t a n c e s b u t , we suggest, poor r e a d e r s of their own m e n t a l
states. T h u s , in t e r m s of t h e rival models of theory-of-mind
development, s u c h children m a y acquire a t h e o r y - t h e o r y of mind
b u t be u n a b l e to u s e simulation of mentalizing with t h e s a m e
confidence a s c a n children w h o s e a t t a c h m e n t (albeit insecure) is
coherent a n d organized. T h e alternative models m a y be more
usefully t h o u g h t of a s alternative r o u t e s to mentalization, the
first (theory-theory) accessible to all, t h e second (simulation)
more readily available to children w h o s e early a t t a c h m e n t rela-
t i o n s h i p s m a d e s u c h a strategy m o r e attractive a n d desirable.
In c h a p t e r 6, we a t t e m p t to describe t h e n o r m a l development
of reflective function in t h e child aged 2 to 5 years. We suggest
t h a t t h e r e is a transition from a d u a l m o d e of experience i o
mentalization. Primarily from a clinical perspective, we a d v a n c e
a n u m b e r of propositions concerning t h e development of the
psychological p a r t o f t h e self. These are:

1. In early childhood, reflective function is characterized by two

m o d e s of relating i n t e r n a l experiences to t h e external situation:
[a] In a serious frame of mind, t h e child expects t h e internal
world in himself a n d o t h e r s to correspond to external reality, a n d
subjective experience will often be distorted to m a t c h information
coming from outside—psychic equivalence mode (e.g., Gopnik
a n d Astington 1988; Perner, Leekam, a n d W i m m e r 1987). (b)
While involved in play, t h e child k n o w s t h a t i n t e r n a l experience
m a y n o t reflect external reality (e.g., B a r t s c h a n d Wellman 1989;
Dias a n d Harris 1990), b u t t h e n t h e i n t e r n a l s t a t e is t h o u g h t to
 Attachment and Reflective Function / 57

have n o relationship to t h e outside world a n d to h a v e n o implica-

tions for it {pretend mode).

2. In n o r m a l development, t h e child integrates t h e s e two m o d e s

to arrive a t t h e stage of mentalization—or reflective mode—in
which m e n t a l s t a t e s c a n be experienced a s r e p r e s e n t a t i o n s .
Inner a n d o u t e r reality c a n t h e n be seen a s linked, yet t h e y a r e
accepted a s differing in i m p o r t a n t ways a n d n o longer h a v e to b e
either e q u a t e d or dissociated from e a c h other (Baron-Cohen
1995; Gopnik 1993).

3. We h a v e hypothesized t h a t mentalization normally comes

a b o u t t h r o u g h t h e child's experience of h i s m e n t a l s t a t e s being
reflected on, prototypically t h r o u g h experience of s e c u r e play
with a p a r e n t or older child, w h i c h facilitates integration o f t h e
pretend a n d psychic equivalence modes, t h r o u g h a n interper-
sonal p r o c e s s t h a t is p e r h a p s a n elaboration of t h e complex
mirroring of t h e infant by t h e caregiver. In playfulness, t h e
caregiver gives t h e child's ideas a n d feelings (when he is "only
pretending") a link with reality by indicating t h e existence of a n
alternative perspective, w h i c h exists outside t h e child's m i n d .
The p a r e n t or older child also s h o w s t h a t reality m a y be distorted
by acting u p o n it in playful ways, a n d t h r o u g h this playfulness a
pretend b u t real m e n t a l experience m a y be introduced.

4. In t r a u m a t i z e d children, i n t e n s e emotion a n d associated

conflict c a n b e t h o u g h t of a s having led to a partial failure of this
integration, so t h a t a s p e c t s of t h e p r e t e n d m o d e of functioning
become p a r t of a psychic equivalence m a n n e r of experiencing
reality. This m a y be b e c a u s e w h e r e m a l t r e a t m e n t or t r a u m a h a s
occurred within t h e family, t h e a t m o s p h e r e t e n d s to be incom-
patible with t h e caregiver "playing with" t h e m o s t p r e s s i n g as-
pects of t h e child's t h o u g h t s ; t h e s e are often d i s t u r b i n g a n d
u n a c c e p t a b l e to t h e adult, j u s t a s t h e y a r e to t h e child. T h e rigid
and controlling behavior of t h e preschool child with a history of
disorganized a t t a c h m e n t is t h u s s e e n a s arising o u t of a partial
failure on t h e p a r t of t h e child to move beyond t h e mode of
psychic equivalence in relation to specific ideas or feelings, so
58 / Theoretical Perspectives

t h a t he experiences t h e m with t h e intensity t h a t m i g h t b e ex-

pected h a d they b e e n c u r r e n t external events.

THE IMPLICATIONS OF REFLECTIVE FUNCTION

FOR SELF-DEVELOPMENT

"Mind-reading" m a y n o t be a n unequivocally positive experience.

J u d y D u n n ' s work, however, gives u s a n indication t h a t a t least
t h e u n d e r s t a n d i n g of emotion a t t h e age of 3V4 predicts a positive
perception of social relations, m a t u r e moral sensibility, a n d the
u n d e r s t a n d i n g of complex emotions (Herrera a n d D u n n 1997).
S t e r n (1985) pointed o u t t h a t a s e n s e of ownership of one's
actions—whether derived from t h e experience of forming plans,
proprioceptive feedback, or t h e objective c o n s e q u e n c e s of physi-
cal actions on t h e e n v i r o n m e n t — c o n t r i b u t e s significantly to t h e
s e n s e of self-agency. In o u r view, s u c h agency also crucially
d e p e n d s on t h e quality a n d reliability of reflective function, a s
ownership of action is intimately tied to t h e m e n t a l s t a t e (belief
or desire) t h a t initiated it. It is impossible to conceive of self-
agency a s fully established by t h e a c t u a l a c t i o n s of t h e child, a s
s u c h a large proportion of t h e s e will fail to achieve their intended
objective b e c a u s e of t h e child's i m m a t u r e physical a n d cognitive
capacities. In fact, it could be a r g u e d t h a t if t h e s e n s e of self-
agency were uniquely b a s e d o n feedback from i m m a t u r e action
systems, deficiency in this s p h e r e would be universal. T h e recog-
nition of t h e child's intentional s t a n c e by (older) o t h e r s m u s t ,
t h e n , be critical in m a k i n g t h e t h o u g h t "real" for t h e child.
Interpersonal interaction t h a t p e r m i t s t h e registration of percep-
tions, t h o u g h t s , a n d emotions a s c a u s e s a n d c o n s e q u e n c e s of
action a n d t h e contemplation of t h e s e m e n t a l s t a t e s w i t h o u t fear
m u s t constitute a n i m p o r t a n t p a r t of t h e foundation of self-
agency. T h e earliest foundation is p r e s u m a b l y t h e b a b y ' s sense
t h a t h e brings a b o u t t h e caregiver's mirroring behavior (Gergely
a n d W a t s o n 1996). This idea is a t t h e core of c h a p t e r 4.
Of course, t h e core of self-agency m u s t lie in t h e body, where
t h e infant's effort to be in control often s u c c e e d s after t h e earli-
est times. However, more complex actions, particularly those
 Attachment and Reflective Function / 59

t h a t involve o t h e r s in t h e child's world, frequently require t h e

reflective caregiver to m a k e s e n s e of t h e y o u n g child's w i s h e s
a n d to e x p r e s s these, if t h e two-way connection between inten-
tions a n d action is to be established. Hence, t h o s e w h o have
experienced severe neglect or coercive, rigid, frightening, a n d , a t
a n extreme, a b u s i v e p a r e n t i n g will frequently experience their
sense of self-agency a s massively curtailed a n d confined to t h e
more finnly established bodily d o m a i n (see c h a p t e r s 9 a n d 10 for
a full exploration of t h i s idea).
The model of t h e development of mentalizing capacity t h a t
we propose h a s considerable clinical implications. For example,
in a s t u d y of a t t a c h m e n t classification in p a t i e n t s with severe
personality disorders, Fonagy et al. (1996) found t h a t t h e AAI
narratives of borderline-personality-disordered p a t i e n t s h a d
lower reflective function, coupled with histories of severe t r a u m a ,
which w a s a p p a r e n t l y unresolved. The findings suggest t h a t ,
given a sensitive a t t a c h m e n t relationship, w h i c h provides t h e
intersubjective b a s i s for t h e development of mentalizing capac-
ity, t r a u m a (even if severe) is m o r e likely to be resolved. Severe
distortion of personality follows w h e n a b u s e or neglect leads to a
defensive inhibition of mentalization. Similarly, evidence is accu-
mulating t h a t a m o n g juvenile offenders, w h e r e histories of mal-
t r e a t m e n t a r e c o m m o n , capacities for mentalization are severely
restricted (Blair 1995; Levinson a n d Fonagy 2000). The evidence
on d i s t u r b a n c e s of mentalization a m o n g clinical g r o u p s is elabo-
rated m o r e fully in later c h a p t e r s (see c h a p t e r s 10 a n d 11 in
particular).

A DEVELOPMENTAL FRAMEWORK
FOR ABNORMAL REFLECTIVE FUNCTION

It would b e u n d o u b t e d l y overly simplistic to m a k e a n a b s o l u t e

connection between developmental disorder a n d nonreflective-
ness. There a r e variations a c r o s s situations, or, p e r h a p s m o r e
accurately, a c r o s s relationships. The delinquent adolescent is
well aware of t h e m e n t a l s t a t e s of other g a n g m e m b e r s , a n d t h e
borderline individual a t times s e e m s hypersensitive to t h e affec-
60 / Theoretical Perspectives

tive s t a t e s of m e n t a l h e a l t h professionals a n d family m e m b e r s .

These "anomalies" m a y be clarified by more sophisticated devel-
opmental theory.
O u r c h o s e n framework is provided by "dynamic skills theory"
(Fischer a n d F a r r a r 1987; Fischer, Kenny, a n d Pipp 1990), which
depicts development a s a p e r s o n ' s elaboration of progressively
more complex control s y s t e m s (skills). Reflective function m a y be
readily conceived of a s one s u c h control system, critical to the
organization of t h e self. Within d y n a m i c skills theory, reflective
function would be seen a s n o t simply a property of t h e person,
b u t o f t h e p e r s o n a n d situation together, b e c a u s e all skills are
composed of b o t h t h e p e r s o n ' s activities a n d t h e s i t u a t i o n s or
context within w h i c h t h e s e occur. Particular t a s k s , specific
events, other people, a s well a s c u l t u r e are s e e n a s p a r t of the
skill. F u r t h e r m o r e , t h e development of a skill is n o t s e e n a s
progression along a n y singular p a t h , determined by m a t u r a t i o n .
Rather, reflective function, a s a skill, evolves t h r o u g h varied
pathways, molded by m a n y dynamically interacting influences,
s u c h a s t h e individual's emotions, social interaction, family rela-
t i o n s h i p s a n d environment, i m p o r t a n t social g r o u p s , t h e reac-
tions o f t h e wider social world,, a n d so forth (Fischer.Knight, a n d
V a n P a r y s 1993).
Reflective function is a s t r a n d within t h e developmental
web, one of t h e m a n y distinct control s y s t e m s t h a t a r e neither
strongly connected with e a c h other n o r coordinated or integrated
(Fischer a n d Pipp 1984). T h e "fractionation" or splitting of all
abilities a s a function of t a s k s a n d d o m a i n s is well d e m o n -
strated, a n d we m i g h t expect reflective function to b e subject
to t h e s a m e k i n d of developmental decalage [unevenness] t h a t
characterizes t h e r e s t of cognitive development (Flavell 1982).
"Fractionation" refers to t h e t e n d e n c y for a p e r s o n n o t to coordi-
n a t e skills or experiences t h a t a r e - n a t u r a l l y s e p a r a t e b u t may
be t h o u g h t of a s belonging together by s o m e external criterion
(Fischer a n d Ayoub 1994). J u s t a s t h e u n d e r s t a n d i n g of conser-
vation of liquid does n o t generalize to conservation of area,
reflective capacity in o n e d o m a i n of interpersonal interaction
should n o t be expected to generalize to others. Reflective func-
tion does n o t begin a s a general capacity, b u t is a p a r t i c u l a r skill
tied to t h e t a s k a n d d o m a i n w h e r e it is learned—a specific

&
 Attachment and Reflective Function / 61

category of relationship. Reflective function a s a skill m a y be

more or less p r e s e n t in s i t u a t i o n s a s a function of contextual
s u p p o r t a n d emotional s t a t e s t h a t p u s h a n individual u p or
down a developmental s t r a n d . Differences in t h e m e a n i n g of a n
interaction a s well a s its physical context c a n lead to fraction-
ation. For example, t h e concept of conservation of liquid m a y n o t
generalize b e t w e e n t h e experimental t a s k a n d o n e t h a t involves
helping a thirsty friend, even if b o t h involve p o u r i n g a glass of
orange j u i c e (Rogoff 1990). We have noted above t h a t t h e child's
observed u s e a n d experience of m e n t a l - s t a t e l a n g u a g e c a n differ
markedly a c r o s s social contexts ( D u n n 1996). Fractionation does
not d i s a p p e a r entirely with development, either in general or in
the specific c a s e of reflectiveness. It is clearly possible for t a s k -
based skills s u c h a s reflective function to come to b e coordi-
nated, b u t t h i s s h o u l d n o t be s e e n a s a u t o m a t i c . U n e v e n n e s s
across s i t u a t i o n s is likely to r e m a i n prevalent even in adults,
especially w h e n t h e y are emotional (Fischer a n d Ayoub 1994).
Normal development proceeds from fractionation toward inte-
gration, w h i c h involves t h e construction of specific coordinations
among previously s e p a r a t e skills a n d provides t h e foundation for
more complex, sophisticated control s y s t e m s (Bidell a n d Fischer
1994). Abnormalities of reflective function, t h e c o n t i n u e d u s e of
a teleological r a t h e r t h a n a mentalizing model for predictive
behavior, s h o u l d not, t h e n , be s e e n a s either a c o n s e q u e n c e of
"arrest a n d fixation" a t a n early stage or a "regression" to t h a t
stage. Pathologies in t h e reflective function of t h e maltreated
child m a y b e expected to develop increased complexity with age
and time, in a m a n n e r similar to other skills. T h e skill for limited
reflectiveness developed by t h e child to anticipate a n d forestall
m a l t r e a t m e n t a n d its painful physical a n d psychological i m p a c t
would be adaptive in their p a r t i c u l a r world b u t would b e ex-
pected to p r o d u c e sophisticated forms of difficulty r a t h e r t h a n
straightforward a d a p t a t i o n s in o t h e r contexts (Noam 1990). T h e
ability to be reflective in general, b u t to s h o w only minimal re-
flectiveness in t h e context of one's own childhood with reference
to the m e n t a l s t a t e s of "caregiving" o t h e r s or in specific relation-
ships t h a t reactivate t h e s a m e s c h e m a t a , could be a r e s u l t of
n a t u r a l fractionation. U n e v e n n e s s or splitting of reflective ability
could also be t h e c o n s e q u e n c e of a n active (purposeful, con-
62 / Theoretical Perspectives

scious, or unconscious) a t t e m p t on t h e p a r t o f t h e individual n o t

to coordinate or generalize reflective function to specific relation-
ship d o m a i n s . Here t h e u n e v e n n e s s is "a developmental achieve-
ment," in t h a t t h e p e r s o n m u s t create a coordination in order
actively to m a i n t a i n t h e s e p a r a t i o n of contexts t h a t would n a t u -
rally move toward integration. The family might, of course, s u p -
port s u c h splits with s h a r p dissociations between their public,
proper world a n d their private tyrannical one. T h e split is con-
text-: a n d affect-dependent, a n d skills developed within one con-
text will n o t necessarily be m a t c h e d by similar abilities in others.
Within a n a t t a c h m e n t - t h e o r y framework we m i g h t s a y t h a t t h e
self is organized so t h a t certain internal working models include
considerable reflective c o m p o n e n t s — e x p e c t a t i o n s incorporating
t h e m e n t a l s t a t e s of self a n d other—while other working models
of relationships a p p e a r impoverished, indicating only minimal
mentalizing skills. In t h e latter contexts t h e subject will offer
only stereotyped, simple, concrete, low-level descriptions. This
does not imply developmental delay or regression; r a t h e r , it
suggests a r e m a r k a b l y complex ability to coordinate two distinct
levels of functioning. It is t h e function of t h e abusive or emotion-
ally depriving world within w h i c h they developed t h a t engen-
dered in t h e m t h e sophisticated skills required for s u c h a n
a d a p t a t i o n . T h u s to talk of deficit or a b s e n c e of a capacity in
s u c h individuals would u n d o u b t e d l y be a n oversimplification.
M e a s u r e s of global abilities will n o t yield difference between
t h e s e individuals a n d other groups. Efforts a t going beyond m e r e
clinical i m p r e s s i o n in t e r m s of m e a s u r e m e n t a n d quantification
h a v e to t a k e on .board t h e u n e v e n n e s s of their abilities a n d the
situational a n d interpersonal specificity of t h e failure of reflec-
tive function.
In o u r view, nonreflective internal working models come
to d o m i n a t e t h e behavior of personality-disordered a d u l t s a n d
children w h e n a n e l e m e n t of conflict is p r e s e n t within a n inter-
personal relationship. Conflict—or, r a t h e r , its adaptive resolu-
tion-^-prototypically calls for t h e perception b o t h o f t h e self a n d of
t h e other in relation to t h e self, requiring individuals to reconcile
their own legitimate claims with c o n c e r n for t h e other (Killen a n d
Nucci 1995). T h u s , for example, t h e a b n o r m a l i t y of t h e early
family environment of individuals with severe p r o b l e m s of con-
 Attachment and Reflective Function / 63

duct h a s b e e n m o s t evident in t h e context of normally expectable

conflicts (Patterson 1982; Perry, Perry, a n d Kennedy 1992). In
this context t h e child with a vulnerable capacity for mentaliza-
tion experiences n o affirmation of h i s intentional s t a n c e a n d fails
to acquire t h e s e n s e of ownership or i n n e r e n d o r s e m e n t of his
actions t h a t is essential for a s e n s e of self-agency. Consequently,
his s e n s e of a u t o n o m y b e c o m e s vulnerable, a n d t h e i m p o r t a n c e
of his original i n t e n t i o n is exaggerated. T h e characteristics of
oppositional defiant disorder (e.g., negativity, disobedience, ag-
gression) m a y in p a r t be s e e n a s a t t e m p t s a t r e a s s e r t i n g self-
agency in a relationship w h e r e t h e connection between m e n t a l
state a n d action within t h e self h a s b e e n u n d e r m i n e d by insensi-
tive a n d coercive parenting. ^
Abnormalities of p a r e n t i n g r e p r e s e n t b u t o n e route to limita-
tions on reflective function. T h e child's biological vulnerabilities,
s u c h a s hyperactivity, i n a d e q u a t e attentiveness, deficiencies in
impulse control, a r e all likely to o b s t r u c t h i s opportunity for
evolving a mentalized reflective model of conflictual interper-
sonal situations. Within a dialectic or t r a n s a c t i o n a l model t h e r e
is a bidirectional causality i n h e r e n t to s u c h biological vulner-
abilities: t h e y b o t h provoke s i t u a t i o n s of conflict a n d gravely
limit t h e child's capacity to h a n d l e t h e m flexibly (see c h a p t e r 9).
The s e p a r a t i o n of action from intention u n d e r m i n e s t h e emo-
tional reaction individuals m a y b e expected to h a v e in relation to
the c o n s e q u e n c e s of their action, since, a s Hart a n d Killen
pointed out, t h e acquisition of moral emotions r e q u i r e s t h a t
individuals a r e "active c o n t r i b u t o r s to their own development,
interpreting their world a n d m a k i n g j u d g m e n t s t h a t determine
their actions in it" (1995, p. 7). S u b s e q u e n t l y , t h e p r e d o m i n a n t
response to s i t u a t i o n s charged with emotion will be a nonreflec-
tive one, readily disowned by t h e self. Naturally t h e a b s e n c e of
reflective function in s u c h s i t u a t i o n s will give t h e a p p e a r a n c e of
rigidity to t h e p e r s o n ' s behavior, a s if only a singular p a t t e r n of
response were accessible. F u r t h e r m o r e , t h e r e s p o n s e m a y fre-
quently be in conflict with social n o r m s b e c a u s e t h e t e n d e n c y to
take t h e perspective of o t h e r s h a s b e e n a b a n d o n e d in t h a t con-
text, a n d c o n s e q u e n t l y t h e "moral emotions" u s e d to m a k e
j u d g m e n t s a b o u t t h e c o n s e q u e n c e s of actions a n d to regulate
behavior (Arsenio a n d Lover 1995) a r e a b s e n t . T h e a b s e n c e of
64 / Theoretical Perspectives

reflective function m a y further exaggerate a n antisocial r e s p o n s e

by forcing t h e individual to see t h e other n o t a s a n o t h e r inten-
tional agent, b u t , r a t h e r , in n o n h u m a n t e r m s , a s a body, a s
representing a social position or agency, or a s a n a n o n y m o u s
m e m b e r of a group.
Maltreatment, or m o r e broadly t r a u m a , is seen a s interacting
with t h e domain- a n d situation-specific restrictions on reflective
function a t two levels: (a) As we have argued, m a l t r e a t m e n t
p r e s e n t s t h e y o u n g child with a powerful emotional disincentive
for t a k i n g t h e perspective of o t h e r s b e c a u s e o f t h e a c t u a l hostility
o f t h e intentional s t a n c e o f t h e a b u s e r , a s well a s t h e c o n s t r a i n t s
u p o n self-development imposed by a n older p e r s o n ' s failure to
u n d e r s t a n d a n d acknowledge t h e child's b u d d i n g s e n s e of inten-
tionality. (b) T h e child is deprived of t h e resilience provided by
t h e capacity to u n d e r s t a n d a t r a u m a t i c interpersonal situation
(Fonagy et al. 1994). T h u s individuals t r a u m a t i z e d by their fam-
ily environment are vulnerable in t e r m s b o t h of t h e long-term
maladaptive effect of their reaction to t h e t r a u m a a n d of their
reduced capacity to cope with it. The p r e d o m i n a n t l y n o n m e n -
talizing s t a n c e adopted in s u c h s i t u a t i o n s therefore further im-
pairs t h e individual a n d , in t h e extreme, their nonmentalizing
a p p r o a c h will come to d o m i n a t e all i n t i m a t e interpersonal rela-
tionships. It is a t t h i s stage t h a t severe developmental psychopa-
thology—ultimately e n t r e n c h e d personality disorder—becomes
t h e likely outcome.
 Historical a n d Interdisciplinary
I Perspectives o n Affects
a n d Affect Regulation

In this c h a p t e r , we follow o u t t h e implications of t h e a r g u m e n t in

the first c h a p t e r concerning t h e developmental m e c h a n i s m s t h a t
produce mentalization a n d reflective function. Here we examine
the relationship of early object relations with mentalization
t h r o u g h t h e l e n s of affects a n d affect regulation. T h i s c h a p t e r
provides a historical overview of academic traditions concerning
affects a n d affect regulation from t h e perspective of mentaliza-
tion. T h e c h a p t e r is n o t intended a s a n y kind of exhaustive
review—an ambition t h a t is s u b s t a n t i a l l y beyond t h e scope of
this work. O u r a i m h e r e is to point to key controversies in t h e
study of emotion. T h e review highlights t h e fact t h a t a n a l o g o u s
dichotomies exist a c r o s s a n u m b e r of disciplines. Both philo-
sophical a n d psychological traditions t e n d to regard affects in
one of two ways: (a) ideally a s integrated with cognition, a n d (b)
a s inherently i n d e p e n d e n t of, opposed to, a n d o u t of t h e control
of rational t h o u g h t . Certain n e u r o s c i e n t i s t s have suggested t h a t
both traditions m a y have s t r o n g foundations in t h e b r a i n struc-
tures a s s u m e d to m e d i a t e emotional experience. Psychoanalysts,
including F r e u d , h a v e also p u r s u e d b o t h lines of t h o u g h t , with
notable individual exceptions. We review t h e contribution of
a t t a c h m e n t t h e o r i s t s in some detail, since t h i s framework repre-
sents t h e s t a r t i n g point for m a n y of t h e ideas in t h e c u r r e n t

65
66 / Theoretical Perspectives

m o n o g r a p h . In t h e a t t a c h m e n t theory tradition, t h e r e is a com-

m i t m e n t to explore precisely how affective experience contrib-
u t e s to t h e acquisition of self-regulation b y v i r t u e of coregulation
between caregiver a n d infant. T h e p r e s e n t c h a p t e r places our
a p p r o a c h , w h i c h is also b a s e d in t h e developmental tradition
already outlined briefly in c h a p t e r 1, into a historical frame of
reference,, insofar a s we a t t e m p t to integrate t h e two major
intellectual traditions concerning affect.

INTRODUCTION

There is a n e n o r m o u s a n d growing interest in affects across

disciplines. Both in a t t a c h m e n t theory a n d in m a n y other do-
m a i n s in psychology, one i m p o r t a n t c o m p o n e n t of t h i s interest
in affects c e n t e r s on affect regulation. Yet, a s m a n y scholars
have observed, t h e concept of affect regulation h a s never b e e n
well d e n n e d (Gross 1998, 1999; Magai 1999; R. T h o m p s o n 1990,
1994). For some theorists, affect regulation, or w h a t is some-
times referred to a s "emotion regulation," d e n o t e s a process
wherein t h e object of regulation is t h e affect/emotion itself
(Eisenberg a n d F a b e s 1992; N. Fox 1994; G a r b e r a n d Dodge
1991). For a t t a c h m e n t t h e o r i s t s a n d p s y c h o a n a l y s t s , however,
t h e object of regulation is m o r e complex: t h e regulation of affects
is linked to t h e regulation of t h e self. More precisely, affect
regulation plays a crucial p a r t in t h e explanation of h o w infants
move from a state of coregulation to self-regulation. T h e s t a k e s
a r e greater in t h e way p s y c h o a n a l y s t s a n d a t t a c h m e n t theorists
conceive of affect regulation.
Affects a n d affect regulation a r e n o t necessarily complemen-
tary concepts. Affect regulation entails t h e capacity to control
a n d m o d u l a t e o u r affective r e s p o n s e s . However, we shall con-
sider s o m e of t h e a r g u m e n t s of t h o s e w h o do n o t agree t h a t
affects c a n be b r o u g h t u n d e r regulation. It is i m p o r t a n t , there-
fore, to begin t h i s inquiry by t a k i n g a look a t various s o u r c e s a n d
d e b a t e s concerning t h e n a t u r e of affects a n d affect regulation.
This historical b a c k g r o u n d illuminates t h e w a y in w h i c h certain
 Affects and Affect Regulation / 67

beliefs a b o u t affects c o n t i n u e to inform c o n t e m p o r a r y perspec-

tives. We begin, in t h e first p a r t of t h i s chapter, with philosophi-
cal perspectives o n affects a n d affect regulation; w e move o n to
psychological perspectives a n d t h e n t u r n to neuroscientific
perspectives. In t h e second part, we examine affects a n d affect
regulation in p s y c h o a n a l y s i s a n d t h e n a t t a c h m e n t theory.

PHILOSOPHICAL PERSPECTIVES

In t h e W e s t e r n philosophical tradition, t h e c o m m i t m e n t to ra-

tionality a s t h e ideal s t a n d a r d to guide action m e a n t t h a t affects
were minimized in importance. At t h e s a m e time, m o s t major
philosophers h a v e felt t h e need to try to h a v e s o m e a c c o u n t of
affects, a n d even philosophers w h o a r e s t a u n c h defenders of
rationality, like Descartes, h a v e h a d profound t h i n g s to say
a b o u t affects. 1 We do n o t a t t e m p t to p r e s e n t a detailed inquiry
a b o u t h o w affects have b e e n u n d e r s t o o d in t h e history of phi-
losophy in t h i s context. For o u r p u r p o s e s , it will be sufficient to
emphasize a crucial d e b a t e concerning t h e n a t u r e of affect
within t h e history of philosophy t h a t r e m a i n s extremely relevant
today for u n d e r s t a n d i n g affects a n d affect regulation. In c h a p t e r
5, on t h e self a s agent, we a d d r e s s c o n t e m p o r a r y ideas from t h e
philosophy of m i n d in connection with t h e t h e m e of intersubjec-
tivity.
For Aristotle, affects a r e f u n d a m e n t a l for t h e p u r s u i t a n d
a t t a i n m e n t of a good a n d h a p p y h u m a n life. He regards affects
as beliefs; a s s u c h , t h e y provide j u d g m e n t s a b o u t t h e world t h a t
can be justified or not. This m e a n s t h a t , by themselves, affects
are n e i t h e r h a r m f u l n o r opposed to r e a s o n . As Aristotle s e e s it,
affects b e c o m e h a r m f u l only insofar a s o u r c h a r a c t e r s a r e too

1
Descartes is often singled out for criticism concerning his belief that reason,
and reason alone, guarantees knowledge. However, Descartes' treatise The Pas-
sions of the Soul is devoted to the treatment of affects, stressing the importance
of the role of the body in affects. For an original perspective on just how seriously
Descartes and other seventeenth-century philosophers took affects, see S.
James 1997.
68 / Theoretical Perspectives

w e a k to c o u n t e r a c t a n d m o d e r a t e t h e m . 2 He does n o t deny t h a t
affects c a n become excessive; r a t h e r , h e s t r e s s e s t h a t t h r o u g h
practice we c a n learn to have t h e m in t h e a p p r o p r i a t e way—that
is, a t t h e right time, in t h e right way, a n d toward t h e right
people.
Aristotle is t h e first philosopher who, it is fair to s u r m i s e ,
p o s t u l a t e d a theory of affect regulation. For him, regulating
affects d e p e n d s u p o n crafting t h e m to occur within t h e interme-
diary c o u r s e between t h e extremes of either excess or deficiency.
In other words, we c a n d i s t i n g u i s h between a n g e r a s conforming
to t h e m e a n a n d its extremes—excess, w h i c h we c a n call irasci-
bility; a n d t h e deficiency, w h i c h we c a n call irritation (Barnes
1984;. Rhetoric 1378a31). 3 Aristotle w i s h e s to u r g e u s to cultivate
o u r c h a r a c t e r s in order to b e able to discern how to act in a way
t h a t places affects u n d e r o u r control. He a p p r e c i a t e s t h e values
of affects, a n d h e particularly s t r e s s e s how integrally connected
p l e a s u r e is with affective experience (Gosling a n d Taylor 1982;
J u r i s t 1998; Stocker a n d H e g e m a n 1996). P e r h a p s , m o s t impor-
tantly, h e fashions a n ideal for h u m a n a g e n t s of integrating
r e a s o n a n d feeling.
Countering Aristotle, t h e Stoic p h i l o s o p h e r s challenge the
notion t h a t affects c a n be m o d u l a t e d . In their view, affects are
beyond o u r control a n d necessarily elude cultivation; t h i s ex-
plains why we often feel t h a t affects h a p p e n to u s , r a t h e r t h a n
t h a t they are c h o s e n by u s . T h e Stoics regard affects a s false
j u d g m e n t s a n d h e n c e a s c o r r u p t i n g forces t h a t lead u s a s t r a y .
It behooves u s , therefore, to d i s t a n c e ourselves from affects a n d
to strive to a c t on t h e b a s i s of rationality alone. If we m a n a g e to
withhold o u r c o n s e n t to t h e overpowering force of affects, we c a n
achieve t h e "detachment" a n d "self-sufficiency" by virtue of
which we are able to flourish.

"The Ancient Greek virtue, sophrosune, concerns the regulation of pleasure

and bodily appetites. Sophrosune has to do with finding the right amount of
pleasure, not restricting or devaluing it.
3
Aristotle makes the point that it is difficult to find the, right word for the
deficiency of anger, thereby acknowledging that anger is the kind of affect that is
more likely to be excessive.
 Affects and Affect Regulation / 69

The Stoic view h a s h a d a d o m i n a n t influence o n t h e history of

philosophy. T h i s is particularly striking in t e r m s of t h e philo-
sophical propensity to c o n s t r u e irrationality strictly in t e r m s of
being a failure of rationality, r a t h e r t h a n a s having a m e a n i n g in
its own right. Moreover, Stoic philosophy h a s h a d a n i m p o r t a n t
influence on early C h r i s t i a n thinking, wherein affects a n d t h e
body a r e portrayed in negative t e r m s . T h e ambivalence in Chris-
tianity toward affects is illustrated by D e S o u s a in t h a t five o u t of
the seven m a i n vices are affects (pride, lust, envy, gluttony,
anger, a n d sloth, b u t n o t avarice a n d greed), a n d three o u t o f t h e
four c a r d i n a l virtues concern resisting emotional t e m p t a t i o n s
(prudence, fortitude, a n d t e m p e r a n c e , b u t n o t justice) (1987,
p. 17). Reflecting on t h e history of philosophy h a s m o r e t h a n
a n t i q u a r i a n interest: t h e influence of t h e Stoic view h a s h a d real
c o n s e q u e n c e s for t h e self-understanding of o u r culture.
Generally a n d s o m e w h a t bluntly stated, Aristotelians are
friendly toward affects, w h e r e a s Stoics a r e wary of t h e m . 4 Al-
t h o u g h t h e s e a p p e a r to b e m u t u a l l y exclusive paradigms, caution
ought to b e exercised n o t to r e a c h s u c h a conclusion p r e m a -
turely. Indeed, in t u r n i n g to Spinoza, we find a philosopher who
a c c o m m o d a t e s different a s p e c t s of b o t h p a r a d i g m s . Spinoza w a s
greatly influenced by t h e C a r t e s i a n revolution a n d w a s particu-
larly a t t r a c t e d to t h e a i m of rendering philosophy m o r e scientific,
a s is evident from t h e geometrical form of t h e Ethics (Spinoza,
1677). He d e p a r t e d from Descartes' dualism, however, in conceiv-
ing of h u m a n s a s embodied m i n d s . Descartes' work, The Pas-
sions of the Soul, h a d t h e merit of portraying affects both- a s
s e n s a t i o n s t h a t a r e in t h e body a n d a s mentalistic; in fact, t h e
e m p h a s i s on affects a n d t h e body initiates a n i m p o r t a n t new
direction, w h i c h a n t i c i p a t e s psychology, away from Aristotle's
conception of t h e m a s beliefs. Yet a problem arises for Descartes
in having to give a n a c c o u n t of h o w t h e mind i n t e r a c t s with t h e
body. Spinoza neatly b y p a s s e s t h i s problem b e c a u s e h e insists
t h a t bodily experience is directly accessible.to t h e m i n d (1677,
p. 12).

4
For an excellent discussion of the relation between Aristotelians and Stoics,
see Nussbaum's The Therapy of Desire (1994).
70 / Theoretical Perspectives

Spinoza w a s strongly influenced by t h e Stoics' view of affects.

He regards affects a s false j u d g m e n t s a n d , hence, u r g e s u s to
strive to resist acting u p o n t h e m a n d to accept t h a t t h e y elude
o u r control. Nonetheless, in Part III o f t h e Ethics, Spinoza a r g u e s
t h a t we o u g h t n o t simply to reject or forsake affects; r a t h e r ,
reason s h o u l d be -used to correct affects w i t h o u t dismissing
them. O u r self-understanding is improved, according to Spinoza,
by u n d e r s t a n d i n g o u r affects. From a clinical point of view, w h a t
is especially interesting a b o u t Spinoza is h i s suggestion t h a t the
affective s t a t e m u s t be preserved in t h e way r e a s o n is applied to
it. (We r e t u r n to t h i s idea later in t h e chapter.) In appreciating
t h a t affects enrich o u r lives, h e exhibits s y m p a t h y for t h e Aristo-
telian h o p e of integrating feeling a n d r e a s o n . T h u s , it is impos-
sible to place Spinoza neatly into either t h e Aristotelian or the
Stoic c a m p .
T h e d e b a t e between Aristotelians a n d Stoics h a u n t s t h e his-
tory of t h i n k i n g a b o u t affects. C a n affects be cultivated? Do they
give m e a n i n g to h u m a n life, a n d a r e t h e y i n d i s p e n s a b l e to the
way we imagine h u m a n thriving? Or a r e t h e y primitive forces
t h a t are d a n g e r o u s to o u r well-being? One kind of philosophical
a p p r o a c h to t h i s d e b a t e is primarily to c o n c e n t r a t e o n t h o s e
affects t h a t one d e e m s a s valuable a n d a s c o n t r i b u t i n g to moral
c o n d u c t . H u m e t a k e s s u c h a position: h e does n o t claim t h a t all
affects should be regarded a s c o n t r i b u t i n g to morality, b u t he
m a i n t a i n s t h a t morality is b a s e d u p o n feelings a n d could never
be legislated by r e a s o n alone. More recently, m o r a l psychologists
in philosophy like Stocker a n d H e g e m a n (1996), Oakley (1992),
Rorty a n d F l a n a g a n (1990), G r e e n s p a n (1988), D e S o u s a (1987),
a n d C. Taylor (1985) h a v e a r g u e d ' t h a t affects c o n t r i b u t e to
morality a n d t h a t it is m i s t a k e n to conceive of affects a s u n d e r -
mining rationality. In s u m , t h e r e is a growing appreciation b y
philosophers of t h e value of r e t h i n k i n g affects. T h i s does not
m e a n , of course, t h a t t h e r e is a g r e e m e n t a m o n g philosophers.
There r e m a i n s a divide between t h o s e t h i n k e r s w h o w i s h to
define affects in t e r m s of beliefs (like Wollheim 1999) a n d others
who w a n t to reformulate t h e bodily contribution of affects who
are captivated by t h e b u r g e o n i n g scientific r e s e a r c h on affects
(e.g., Griffiths 1997).
 Affects and Affect Regulation / 71

PSYCHOLOGICAL P E R S P E C T I V E S

In c o m p a r i s o n to philosophy, t h e field of psychology h a s always

exhibited a k e e n interest in p h e n o m e n a besides r e a s o n , s u c h a s
motivation. Nevertheless, d u r i n g t h e e r a of behaviorism a n d even
in t h e early p h a s e s of t h e cognitive revolution, affects h a v e
hardly b e e n a t t h e center of r e s e a r c h in psychology. T o m k i n s
(1995a, 1995b) stood a s a relatively lone voice in American
psychology d u r i n g t h e 1950s a n d 1960s in working to develop
Darwin's view t h a t affects a r e revealed t h r o u g h facial expression*
and are designed to lead u s to action. T o m k i n s s t r e s s e d t h a t
affects o u g h t to b e studied in their own right, a n d t h a t t h e y
constitute a n i n d e p e n d e n t s p h e r e of knowledge—distinct
from perception, cognition, a n d memory. According to Tomkins,
affects are p r i m a r y biological motivating m e c h a n i s m s a n d
can, t h u s , be u n d e r s t o o d a s having primacy in h u m a n agency.
Tomkins's work highlights t h e link between affects a n d facial
expressions, a n d , in h i s later writings, h e included t h e impor-
tance of skin r e s p o n s e s (Tomkins 1995b).
Inspired by h i s t e a c h e r Tomkins, E k m a n (1992a; E k m a n a n d
Davidson 1994) h a s , from t h e 1970s to t h e p r e s e n t , c o n d u c t e d
research t h a t d e m o n s t r a t e s t h a t emotions are universal a n d
can be recognized cross-culturally t h r o u g h facial expressions. 5
E k m a n a r g u e s t h a t t h e r e are five "basic emotions"—happiness,
sadness, anger, fear, a n d disgust. T h e s e b a s i c emotions a r e
defined in t e r m s of t h e following n i n e characteristics: distinctive
universal signals, p r e s e n c e in other p r i m a t e s , distinctive physi-
ology, distinctive u n i v e r s a l s in a n t e c e d e n t events, coherence
among emotional response, q u i c k onset, brief duration, a u t o -
matic appraisal, a n d u n b i d d e n occurrence (Ekman 1992a).
E k m a n concedes t h a t t h e evidence s u p p o r t i n g t h e s e n i n e c h a r -
acteristics varies: evidence exists for distinctive p a t t e r n s of auto-
nomic n e r v o u s s y s t e m r e s p o n s e s for anger, fear, disgust, a n d

5
A word about terminology: emotions are biological and universal, whereas
feelings are subjective and particular (influenced by culture, family, and indi-
vidual idiosyncrasy). Affects are inclusive of both emotions and feelings.
72 / Theoretical Perspectives

(tentatively) s a d n e s s , a n d h e claims t h a t u n i q u e p a t t e r n s exist

for e a c h emotion in t h e central n e r v o u s s y s t e m .
Like t h e Stoics, basic-emotions p r o p o n e n t s e m p h a s i z e t h a t
affects happen to u s . It is t h e rapid o n s e t of emotions, according
to E k m a n , t h a t explains w h y we perceive t h e m a s h a p p e n i n g to
u s , a s opposed t o p e r c e i v i n g ourselves to be choosing t h e m . Yet,
unlike t h e Stoics, basic-emotions p r o p o n e n t s value affects a s
contributing to survival a n d a t least in this s e n s e regard t h e m a s
salutary. The basic-emotions p a r a d i g m offers one possible p a t h
to c o n d u c t r e s e a r c h a b o u t affects. There a r e other p a r a d i g m s in
psychology, growing o u t of t h e J a m e s - L a n g e theory (W. J a m e s
1884; Lange 1885), w h i c h h a v e b e e n influential a n d which
we need to consider. Before doing so, however, two criticisms
against E k m a n ' s work need to b e acknowledged.
T h e first criticism of b a s i c emotions p r e s s e s t h e question of
w h e t h e r affects form genuinely discrete categories or w h e t h e r
w h a t is really "basic" a b o u t affects is their d i m e n s i o n s : levels of
arousal, pleasure, a n d activity. For example, Davidson (1992)
a r g u e s in favor of t h e d i m e n s i o n s of "approach a n d withdrawal"
a s basic, t h u s posing a n explicit challenge to E k m a n ' s u n d e r -
s t a n d i n g of basic emotions strictly in t e r m s of facial expressions.
Davidson rightly n o t e s t h a t n o t h i n g in E k m a n ' s s t u d i e s s u s t a i n s
t h e invariability of prototypical expressions—especially w h e n
t h e s e emotions occur s p o n t a n e o u s l y (as opposed to in t h e labo-
ratory). As Davidson a d d s , t h e r e is n o compelling r e a s o n simply
to a s s u m e t h a t a n isomorphic relationship exists between emo-
tions a n d their expressions—there m a y well be a s m u c h variabil-
ity within emotions a s a c r o s s t h e m .
The second criticism of E k m a n ' s w o r k c o n c e r n s its cross-
c u l t u r a l validity. J . Russell (1991) observes t h a t while E k m a n ' s
work on facial expressions s h o w s t h a t emotions a r e similar
a c r o s s c u l t u r e s , we s h o u l d n o t a s s u m e t h a t emotions are identi-
cal in different c u l t u r e s . In a similar vein, Averill (1994) h a s
emphasized t h a t b a s i c emotions are, in essence, a form of classi-
fication, a n d h e w a r n s t h a t t h e adoption of s u c h "prototypes" too
often r e s u l t s in overlooking s e c o n d a r y a n d u n u s u a l emotions.
Shweder, a n anthropologist, develops a n even m o r e radical cri-
tique of t h e basic-emotions view. Shweder c o n c u r s t h a t some
 Affects and Affect Regulation / 73

emotions lack characteristic facial expressions a n d suggests t h a t

we o u g h t to u n d e r s t a n d t h e m a s "complex narrative s t r u c t u r e s
t h a t give s h a p e a n d m e a n i n g to somatic a n d affective experi-
ences" (1994, p. 37). Like Russell a n d Averill, Shweder rejects
the basic-emotions view, regarding it a s a c o n s t r u c t of language
t h a t relies o n a p p r a i s a l s of value r a t h e r t h a n on a n y t h i n g t h a t is
found in n a t u r e .
In raising q u e s t i o n s a b o u t h o w beliefs c a n influence affects,
the c r o s s - c u l t u r a l criticism d r a w s o u r attention to t h e subjective
experience of affects a n d implicitly to o u r potential to alter a n d
craft t h e m . E k m a n m a k e s it clear t h a t h e is primarily concerned
with t h e i n n a t e a n d universal a s p e c t s of emotions; h e avers t h a t
this is t h e p a t h w h e r e b y r e s e a r c h c a n m a k e t h e m o s t progress.
E k m a n specifically disavows t h e subjective experience of affects
a s u n a m e n a b l e to s t u d y " b e c a u s e too little is k n o w n a b o u t how
subjectivity m a p s on to other a s p e c t s of a n emotional experi-
ence" (1992a, p. 175). However, we m a y w o n d e r to w h a t extent
the p r e s e n t a t i o n of affective experience a s found s t a t e s within
the mind is a distortion of its n a t u r e , w h i c h ignores o u r capacity
to p r o c e s s a n d regulate affects.
Many psychologists h a v e focused a t t e n t i o n on how cognition
determines affective experience. Emerging a s a r e s p o n s e to t h e
J a m e s - L a n g e theory, w h i c h stipulated t h a t affects are t h e per-
ceptual recognition of physiological reactions to t h e outside
world, S c h a c h t e r a n d Singer (1962) a r g u e d t h a t cognition is
necessary in o r d e r to help u s to label s t a t e s of general physi-
ological a r o u s a l . T h i s perspective s h a r e s with t h e basic-emotions
view t h e f u n d a m e n t a l b a s i s of affective experience in t h e body;
however, it differs from basic emotions on t h e i s s u e of w h e t h e r
affects c a n be linked to distinctive physiological signs. More
recently, L a z a r u s (1984, 1991, 1994) h a s stressed t h e cognitive
contribution to affects by a r g u i n g t h a t t h e r e is no s u c h thing a s
affective experience w i t h o u t cognition. As h e sees it, t h e startle
response differs from t h e affect of fear precisely on t h e b a s i s t h a t
cognition m u s t a c c o m p a n y t h e latter. T h e primacy of cognition
over affect w a s a c o r n e r s t o n e of t h e theoretical framework t h a t
organized t h e work of early cognitive behavioral t h e r a p i s t s (see,
for example, Beck 1967; M a h o n e y a n d F r e e m a n 1985; Meichen-
74 / Theoretical Perspectives

b a u m 1997). The notion t h a t cognition d e t e r m i n e s t h e n a t u r e of

t h e affect is, however, rejected by other psychologists like Zajonc
(1984), who, in a widely read d e b a t e with L a z a r u s (1984), m a i n -
t a i n s t h a t it Is possible to h a v e affects w i t h o u t a n y a c c o m p a n y -
ing cognition.
M u c h of t h e Zaj o n e - L a z a r u s d e b a t e h a n g s on t h e i s s u e of
w h a t is implied by t h e t e r m "cognition"—whether it is s o m e t h i n g
fairly minimal, like a w a r e n e s s , or s o m e t h i n g fancier, closer to
logical inference (e.g., Mandler 1984). If cognition indicates n o t h -
ing more t h a n a n accompanying a w a r e n e s s of t h e affect, it is less
controversial t h a n if it is s u p p o s e d to denote logical thinking.
The cognitive view of affects n a t u r a l l y s h a r e s a n affinity with
t h o s e who w i s h to e m p h a s i z e t h e concept of affect regulation
(Oatley a n d J o h n s o n - L a i r d 1987; Power a n d Dalgleish 1997).
Indeed, for a n u m b e r of psychologists working o n "emotion regu-
lation," t h e basic-emotions p a r a d i g m is n o t wrong a s m u c h a s it
is viewed a s telling only p a r t o f t h e story a b o u t affects. However,
n o t m a n y of t h e s e psychologists h a v e t a k e n on t h e very difficult
question of t h e knower w h o k n o w s — t h a t is, t h e n a t u r e of t h e
subject w h o performs t h e cognitive evaluation t h a t d e t e r m i n e s
t h e n a t u r e of t h e affect. In seeking a n s w e r s to s o m e of t h e
q u e s t i o n s raised by philosophical a n d psychological perspec-
tives, it is helpful to t u r n to neuroscience.

NEUROSCIENTIFIC PERSPECTIVES

Neuroscience is>a n e w a n d exciting field for t h e s t u d y of affects.

One r e s e a r c h e r w h o h a s become p r o m i n e n t in t h e emerging
subfield of "affective science" is LeDoux (1994a, 1994b, 1994c,
1995, 1996). His work h a s dwelt on t h e emotion of fear in rats,
which, h e believes, is more or less similar a c r o s s species, a n d he
h a s d r a w n a t t e n t i o n to t h e i m p o r t a n c e of t h e a m y g d a l a a s t h e
focal point in t h e b r a i n t h a t d e t e r m i n e s emotional significance.
According to LeDoux, t h e r e are two emotional r e s p o n s e s y s t e m s
in t h e brain: t h e first, w h i c h h a s its origin in t h e amygdala, is
described a s "quick a n d dirty" b e c a u s e it o c c u r s automatically
 Affects and Affect Regulation / 75

and is r a t h e r c r u d e in n a t u r e ; t h e second, w h i c h involves t h e

neocortex, refines o u r capacity to r e s p o n d by featuring a cogni-
tive c o m p o n e n t .
LeDoux does n o t w i s h to locate emotion exclusively in t h e s e
two s e p a r a t e p a r t s o f t h e b r a i n . He is attentive to t h e interaction
between t h e a m y g d a l a a n d t h e neocortex a s well a s to t h e crucial
role of other p a r t s , like t h e h i p p o c a m p u s . In h i s book The Emo-
tional Brain (LeDoux 1996), h e e m p h a s i z e s repeatedly t h a t t h e r e
is n o single place in t h e b r a i n where emotion resides. There are
pathways from a n d to t h e neocortex in t h e amygdala, w h i c h
can be activated by t h a l a m i c s e n s o r y processing (without going
t h r o u g h t h e cortex) a t t h e s a m e time a s t h e cortex is activated
from t h e t h a l a m u s . T h e r e p r e s e n t a t i o n of objects o c c u r s simul-
taneously, b u t distinctly from emotional r e s p o n s e . As LeDoux
p u t s it: "We c a n , in o t h e r words, begin to r e s p o n d to t h e emo-
tional significance of a s t i m u l u s before we fully r e p r e s e n t t h a t
stimulus" (1994a, p. 221).
Emotional processing, t h u s , h a s a n i m m e d i a t e a n d a m e d i a t e
form—the former, while distinct, c o n t r i b u t e s to t h e latter. T h e s e
two r e s p o n s e s y s t e m s a r e labeled "Type I a n d II" (LeDoux 1994a,
1994b). Type I emotional r e s p o n s e s a r e i m m e d i a t e a n d a r e a
product of t h e evolutionary experience of t h e species; indeed,
LeDoux likens t h e m to fixed action p a t t e r n s in a n i m a l s . Basi-
cally, in Type I, e m o t i o n s a r e a u t o m a t i c r e s p o n s e s t h a t occur
from a n initial, c u r s o r y evaluation; t h e y a r e n o t u n d e r o u r
voluntary control. Type II emotional r e s p o n s e s , r a t h e r t h a n be-
ing elicited, are emitted. They a r e specific to t h e individual, n o t
the species, reflecting p a s t experience a n d j u d g m e n t a b o u t t h e
applicability of t h e p a s t to t h e c u r r e n t situation. In c o n t r a s t to
Type I r e s p o n s e s , Type II r e s p o n s e s a r e subject to o u r volitional
control.
LeDoux p r e s s e s t h e distinction between older, more primitive
emotional r e s p o n s e s t h a t have t h e function of being a n "early
warning system"—allowing u s to w a r d off t h r e a t e n i n g stimuli,
despite being s o m e w h a t limited in n a t u r e — a n d more recent a n d
complex emotional r e s p o n s e s t h a t h a v e differentiated functions;
these more differentiated r e s p o n s e s enjoy t h e benefit of percep-
tual completeness a n d a r e subject to o u r control. According to
76 / Theoretical Perspectives

LeDoux, emotional r e s p o n s e s c a n o c c u r in t h e a b s e n c e of cogni-

tive systems, since t h e n e u r a l circuits for emotion a n d cognition,
while interactive, a r e distinct.
Thus, LeDoux's view overlaps with t h e b a s i c - e m o t i o n s view,
a l t h o u g h it p o i n t s t h e w a y to a richer a c c o u n t of affective experi-
ence by introducing Type II emotional r e s p o n s e s , w h i c h are
variable, flexible, a n d voluntary. LeDoux w i s h e s to emphasize
t h a t m u c h of emotional processing o c c u r s outside o u r aware-
n e s s , a n d t h a t in h i s j u d g m e n t "feelings" emerge merely a s a
byproduct—"frills t h a t h a v e a d d e d icing to t h e emotional cake"
(1996, p. 302). Like basic-emotions p r o p o n e n t s , LeDoux mini-
mizes t h e subjective experience of affects, viewing it a s a conse-
q u e n c e of behavioral a d a p t a t i o n t h a t h a s b e e n preserved
t h r o u g h evolution, r a t h e r t h a n having to do with t h e "primary
b u s i n e s s " of affects (LeDoux, 1994c). 6 As a behaviorist a n d socio-
biologist, LeDoux is wary of a n d refrains from exploring self-
reflection. Although h e affirms t h a t affects occur unconsciously,
h e d i s m i s s e s t h e psychoanalytic u n c o n s c i o u s a s "a darker, more
malevolent place" (1996, pp. 29-30).
T h e two-systems view of emotional r e s p o n s e described by
LeDoux is valuable for mitigating t h e t e n s i o n between t h e Aristo-
telian a n d Stoic p a r a d i g m s . At t h e risk of oversimplification, we
c a n say t h a t t h e first s y s t e m of emotional r e s p o n s e c a p t u r e s t h e
Stoic position t h a t affects h a p p e n to u s a n d elude o u r control.
T h e second s y s t e m of emotional r e s p o n s e described by LeDoux
h e l p s to clarify t h a t t h e first s y s t e m is n o t t h e only o n e a n d that,
a s Aristotelians have emphasized, we need to p a y a t t e n t i o n to
o u r capacity to craft affects once they occur.
LeDoux is a w a r e t h a t h i s evolutionary a c c o u n t of affects is
only a s t a r t i n g point. He casually notes, for example, t h a t Type II
emotional r e s p o n s e s d e p e n d on t h e existence of s o m e kind
of self-organization. Without elaborating, LeDoux observes t h a t
"the capacity to h a v e feelings is directly tied to t h e capacity to be
consciously a w a r e of one's self a n d t h e relation of oneself to the

6
Not all neuroscientists would agree with LeDoux on this point; in fact,
Panksepp has criticized LeDoux for minimizing the importance of emotional
feelings (Panksepp 1998, p. 341).
 Affects and Affect Regulation / 77

rest o f t h e world" (1996, p. 125). This s t a t e m e n t tacitly acknowl-

edges t h e n e e d to b r o a d e n t h e basic-emotions a p p r o a c h in t h e
direction of affect regulation. In invoking t h e self, LeDoux is on
the verge of opening a door t h a t h e o p t s n o t to enter.
O t h e r n e u r o s c i e n t i s t s , like P a n k s e p p a n d Damasio, h a v e
taken u p t h e challenge of a d d r e s s i n g t h e relation of affects a n d
the self. For r e a s o n s of space, we will c o n c e n t r a t e on D a m a s i o ' s
work, a l t h o u g h t h i s is n o t m e a n t to minimize t h e contribution of
P a n k s e p p ' s Affective Neuroscience (Panksepp 1998) to t h e field.7
Damasio's neurological r e s e a r c h c o n c e r n s p a t i e n t s with prefron-
tal b r a i n d a m a g e w h o exhibit a n a p p a r e n t inability to feel, al-
t h o u g h they a r e able to reactivate p a s t events into working
memory. In c o n t r a s t to the. n a r r o w focus of LeDoux's a n i m a l
research, w h i c h a d m o n i s h e s u s to look a t very specific functions
in o u r a p p r o a c h to t h e relationship between emotion a n d cogni-
tion, D a m a s i o welcomes large philosophical q u e s t i o n s .
As t h e title of h i s first book, Descartes' Error (Damasio 1994a),
suggests, D a m a s i o w a n t s to reject m i n d - b o d y d u a l i s m a n d espe-
cially t h e a s s u m p t i o n m a d e by philosophers w h o wish to affirm
rationality b y rejecting affects. D a m a s i o ' s a r g u m e n t is t h a t , from
the n e u r a l perspective, emotions a r e constitutive of rationality
itself. As h e observes: "Nature a p p e a r s to have built t h e a p p a r a -
t u s of rationality n o t j u s t on top of t h e a p p a r a t u s for biological
regulation, b u t also from a n d with it" (p. 128). Rationality is
shaped by a n d m o d u l a t e d by body signals; t h u s , t h e body pro-
vides c o n t e n t to t h e m i n d , n o t j u s t life s u p p o r t in being aware of
the condition o f t h e visceral a n d m u s c u l o s k e l e t a l state (p. 160).
Damasio's claim is n o t merely .that t h e body a n d emotions con-
tribute to rationality; h e w a n t s to go further a n d suggest t h a t t h e
reduction of emotion, evident in h i s brain-injured patients, se-
verely impinges u p o n t h e capacity to r e a s o n .
Damasio's m a i n t h e s i s is t h a t t h e r e is interconnection be-
tween cognition a n d emotion within t h e b r a i n system, s u c h t h a t

"Panksepp argues that affective states provide essential scaffolding for all
other forms of consciousness; he suggests that the self has its source in the self-
representation that comes from primitive motor representation within the
brainstem (Panksepp 1998, p. 309).
78 / Theoretical Perspectives

it is artificial to insist on t h e difference b e t w e e n t h e m . This

s t r e s s on interconnection might s e e m to imply t h a t D a m a s i o ' s
position d e p a r t s from those—like Tomkins, E k m a n , Zajonc, a n d
LeDoux—who a s s e r t t h e primacy of affects. 8 However, while
Damasio highlights t h e interaction between emotion a n d cogni-
tion, he would n o t deny t h a t emotions c a n exist w i t h o u t cogni-
tion- He e n d o r s e s a m u l t i p l e - s y s t e m s a p p r o a c h to emotions.
In order to clarify t h e originality of D a m a s i o ' s view, we need to
explore it in m o r e detail. He i n t r o d u c e s h i s own distinction
between p r i m a r y a n d s e c o n d a r y emotions, w h e r e t h e latter come
from acquired r a t h e r t h a n i n n a t e dispositional r e p r e s e n t a t i o n s .
Secondary emotions utilize p r i m a r y emotions, b u t t h e y also give
rise to "feelings''—a technical t e r m t h a t characterizes t h e experi-
ence of c h a n g e s in t h e body l a n d s c a p e reflected in t h e m e n t a l
images thereby invoked (1994a, p. 145). D a m a s i o p o n d e r s why it
is t h a t feelings arise, a s merely a c c o u n t i n g for n e u r o c h e m i c a l
c h a n g e s or t h e notion t h a t they are n e u r a l r e p r e s e n t a t i o n s o f t h e
body l a n d s c a p e a t t h e m o m e n t s e e m s insufficient. He concludes
t h a t we n e e d to u n d e r s t a n d t h e m a n y levels of n e u r a l circuitry in
t h e body, all of w h i c h enable rationality a n d give rise to t h e self
(pp. 147, 161).
D a m a s i o elucidates t h e n e u r a l b a s i s of t h e self by probing
h o w emotions are integrated in rationality itself—which h e t e r m s
t h e "somatic m a r k e r hypothesis." T h e somatic m a r k e r hypoth-
esis s h o w s t h a t o u r decision-making p r o c e s s incorporates gut-
level r e s p o n s e s t h a t are, in fact, a u t o m a t i c signals from t h e body
t h a t protect a n d help u s to limit a n d choose a m o n g possible
options. Somatic m a r k e r s — p a r t o f t h e n e u r a l s y s t e m located in
t h e prefrontal cortices—are "a special i n s t a n c e of feelings gener-
ated from s e c o n d a r y emotions . . . connected, by learning, to
predicted future o u t c o m e s of certain scenarios" (1994a, p. 174).
B u t they also serve a s a p r e l u d e to m o r e a b s t r a c t decision-

8
LeDoux cites Damasio several times in his book, and Damasio. in turn,
cites LeDoux's work on the importance of the amygdala for emotional experi-
ence. Both concur that emotions have been given short shrift among cognitive
scientists. More significantly, Damasio. like LeDoux, believes that there are two
systems of emotions, one subcortical and the other neocortical—which he delin-
eates in terms of primary and secondary emotions. Damasio is also influenced
by Edelman's (1992) distinction between primary and secondary consciousness.
 Affects and Affect Regulation / 79

making, u s i n g a t t e n t i o n a n d working memory. They c a n o c c u r in

a n "as-if m a n n e r — w i t h o u t outside stimulation a n d coming to
our a w a r e n e s s . They help u s to anticipate o u t c o m e s a n d m a k e
new goals, negotiating t h e future by m e a n s of t h e perception of
pleasure a n d p a i n l a n d s c a p e s .
For Damasio, t h e self is implied in a n e u r a l a c c o u n t of emo-
tion a n d especially feelings. He readily acknowledges t h a t t h i s is
a biological s t a t e t h a t repeatedly r e c r e a t e s itself—a m e n t a l con-
struction. Nevertheless, h e w i s h e s to affirm o u r s e n s e of experi-
encing a n ongoing a n d c o n t i n u o u s biological state—of w h i c h
we feel like "an owner a n d knower for most, t h o u g h n o t all,
contents" (1994a, p. 238). He s e e k s to do so w i t h o u t s o u n d i n g
a n a c h r o n i s t i c — t h a t is, m i s t a k e n l y conjuring "a little person, t h e
infamous h o m u n c u l u s , inside y o u r b r a i n contemplating w h a t is
going on" (p. 227).
The concept of t h e n e u r a l b a s i s of a self requires early sensory
cortices, s e n s o r y a n d m o t o r cortical associations regions, a n d
subcortical nuclei. As D a m a s i o sees it, t h e n e u r a l self does n o t
depend on t h e function of language, a l t h o u g h l a n g u a g e does
enable, a m o r e refined form of subjectivity by m e a n s of t h e
creation of verbal n a r r a t i v e s o u t of nonverbal ones. As he formu-
lates this: "Language m a y n o t b e t h e s o u r c e of t h e self, b u t it
certainly is t h e s o u r c e of t h e T" (1994a, p. 243). D a m a s i o does
not explore t h i s suggestive distinction between t h e self a n d t h e I
and, in fact, h a s little to say in h i s b o o k a b o u t w h a t it m e a n s to
be a n "I." We a r e left to w o n d e r how t h e n e u r a l self is related to
w h a t we m i g h t refer to a s t h e phenomenological self. D a m a s i o
also fails to c o n t e n d with t h e influence of t h e factor of c u l t u r e in
this regard; n o r d o e s h e d i s c u s s h u m a n development.
In h i s recent book, The Feeling of What Happens, Damasio
(1999) elucidates h i s earlier work, m o s t importantly by differenti-
ating between t h r e e distinct s e n s e s of self: t h e "proto-self," t h e
"core self," a n d t h e "autobiographical self." T h e proto-self is
based on "the e n s e m b l e of b r a i n devices t h a t continuously a n d
nonconsciously m a i n t a i n t h e body s t a t e within t h e n a r r o w r a n g e
and relative stability required for survival" (p. 22). T h e second
self, t h e core self, e n a b l e s u s to be concerned with t h e experience
of the here a n d now. Core c o n s c i o u s n e s s , on which t h e core self
is based, emerges w h e n "the b r a i n ' s r e p r e s e n t a t i o n devices gen-
80 / Theoretical Perspectives

erate a n imaged, nonverbal a c c o u n t of how t h e o r g a n i s m ' s own

s t a t e is affected by t h e organism's processing of a n object, a n d
w h e n t h i s p r o c e s s e n h a n c e s t h e image of t h e c a u s a t i v e object,
t h u s placing it saliently in a spatial a n d t e m p o r a l context" (p.
169). D a m a s i o s t r e s s e s t h e link between t h e core self a n d emo-
tions; a reliable correlate of a defective core c o n s c i o u s n e s s , he
informs u s , is t h e a b s e n c e of emotions (p. 100).
The autobiographical self is p r o d u c e d by a m o r e complex
kind of c o n s c i o u s n e s s , "extended c o n s c i o u s n e s s . " Extended con-
s c i o u s n e s s provides u s with a n identity a n d s e n s e of personhood;
it m a k e s u s a w a r e of being at a point in individual historical time,
a w a r e of having b o t h a lived p a s t a n d a n anticipated future. The
autobiographical self is predicated o n a n organized record from
r e c o n s t r u c t e d images of t h e o r g a n i s m ' s u n i q u e history. Working
m e m o r y is crucial for t h e autobiographical self in a way in which
it is n o t for t h e core self. T h e autobiographical self, while relying
on t h e core self, a d d s t h e d i m e n s i o n s of p a s t a n d future. Accord-
ing to Damasio, t h e core self is t h e foundation of c o n s c i o u s n e s s ,
a n d t h e autobiographical self is its glory (1999, p. 195). In p a s s -
ing, D a m a s i o observes t h a t t h e s e n s e of self t h a t h a s preoccupied
developmental psychologists, occurring a t a b o u t t h e age of 18
m o n t h s , is t h e autobiographical self. He does n o t a t t e m p t to
a d d r e s s in a n y further detail t h e i s s u e of h o w t h e self develops.
O u r work a t t e m p t s to fill in t h e s e s t a g e s a n d m e c h a n i s m s ,
t h e r e b y u n d e r s c o r i n g t h e i m p o r t a n c e of a developmental per-
spective to u n d e r s t a n d i n g t h e self.
There a r e a n u m b e r of key p o i n t s to articulate a b o u t neuro-
science before moving on to d i s c u s s affects a n d affect regulation
in p s y c h o a n a l y s i s a n d a t t a c h m e n t theory. As we h a v e seen,
LeDoux's proposal of two emotional-response s y s t e m s in the
b r a i n h e l p s to reconceptualize t h e long-standing a n d seemingly
unreconcilable c o n t r a s t between Aristotelians a n d Stoics on af-
fects: t h e first s y s t e m confirms t h e Stoic belief t h a t emotional
r e s p o n s e s are beyond o u r control; t h e second s y s t e m s u p p o r t s
t h e Aristotelian idea t h a t emotional r e s p o n s e s c a n b e regulated.
LeDoux's proposal also offers a potential resolution of t h e de-
bate, briefly m e n t i o n e d above, between t h e psychologists Zajonc
a n d Lazarus: t h e first s y s t e m illustrates how affects c a n occur
without cognition, a s t h e former argues, a n d t h e second system
 Affects and Affect Regulation / 81

shows h o w affects are influenced by cognition, a s t h e latter

argues. LeDoux's view highlights t h e complexity a n d r a n g e of
affective experience: it e n d o r s e s t h e basic-emotions view, while
offering a m o r e fruitful overall a c c o u n t . Yet in invoking t h e self
without building t h i s into h i s theory, LeDoux provides a compel-
ling r e a s o n to p r o d u c e s u c h a n a c c o u n t . Like other psychological
perspectives, LeDoux's r e s t s c o n t e n t with t h e description of cog-
nition acting u p o n affects.
Damasio h a s u n d e r t a k e n a n a m b i t i o u s project of highlighting
the interrelated a r e a s of affects, t h e self, a n d t h e brain. His view
is sensitive to t h e interaction between cognition a n d affects,
especially t h e w a y in w h i c h affects c a n c o n t r i b u t e positively
to cognition (as H u m e a n d c o n t e m p o r a r y philosophers have
argued). D a m a s i o develops t h e notion t h a t affects help to create
and s u s t a i n t h e self in a n original way. He does n o t a t t e m p t to
grapple with t h e i s s u e of how t h e self develops—which we shall
do later in t h i s book. More specifically, in c h a p t e r 5, we focus on
the t h e m e of intersubjectivity, c o n c u r r i n g with D a m a s i o t h a t
aspects of t h e self do n o t d e p e n d on it, b u t t h e n moving on to
pinpoint its crucial role in t h e development of t h e self.
In conclusion, t h e neuroscientific a c c o u n t s of LeDoux a n d
Damasio deepen t h e Spinozistic insight t h a t we a r e embodied
minds. At t h e s a m e time, t h e y t a k e u s beyond m o s t of t h e
philosophical perspectives on affects a s either physical or m e n t a l
(or some c o m b i n a t i o n of both). Neuroscience offers a n a c c o u n t of
affects t h a t is indispensable, however m u c h m o r e t h e r e is to
clarify. It would be foolhardy to imagine t h a t all of t h e p r o b l e m s
concerning affects h a v e b e e n or could be dissolved by neuro-
science. No d o u b t , we are still a t a relatively early stage of
u n d e r s t a n d i n g t h e relation between affects a n d t h e b r a i n . We
have learned e n o u g h , however, to m a k e it impossible for a n y
perspective on affects, including psychoanalysis or a t t a c h m e n t
theory, to ignore n e u r o s c i e n c e . S u c h a s t a n c e does n o t betoken
reductionism. As we shall suggest, t h e s u b t l e a n d sophisticated
attention paid by developmental theory to t h e subjective expe-
rience of affects a n d affect regulation h a s m u c h to offer t h e
neuroscientific a s well a s o t h e r perspectives.
With t h e b a c k g r o u n d of philosophical, psychological, a n d
neuroscientific perspectives in mind, let u s now t u r n to focus on
82 / Theoretical Perspectives

psychoanalytic a n d a t t a c h m e n t perspectives on affects a n d af-

fect regulation. In t u r n i n g to t h e s e perspectives, w e will concen-
trate on development a s well a s t h e subjective experience of
affects. After examining psychoanalytic a n d a t t a c h m e n t perspec-
tives, t h e final section offers a n integration of all of t h e perspec-
tives t h a t h a v e b e e n considered.

PSYCHOANALYTIC P E R S P E C T I V E S

It h a s become almost c o m m o n p l a c e for p s y c h o a n a l y s t s to be-

m o a n t h e lack of a n a d e q u a t e theory of affects. No o n e could
d i s p u t e t h a t affects h a v e occupied a n a w k w a r d place in psycho-
analysis, a n d t h a t t h e y deserve m u c h closer scrutiny. At t h e very
least, it c a n b e observed t h a t a large disparity exists between the
marginal role accorded to affects in t h e theory of psychoanalysis
a n d their e n o r m o u s i m p o r t a n c e in t h e clinical realm. To under-
s t a n d why affects a r e only n o w becoming c e n t r a l in p s y c h o a n a -
lytic thinking, we m u s t begin with Freud.
As is well known, F r e u d .never treated affects in their own
right, a n d he modified h i s views several times, u s u a l l y without
trying to reconcile h i s n e w views with previous ones. Moreover,
F r e u d never a d d r e s s e d t h e q u e s t i o n of how affects could be
closely tied to drives on t h e one h a n d , a n d yet b e so o m n i p r e s e n t
a n d crucial to w h a t o c c u r s in t h e interaction between analyst
a n d p a t i e n t in t h e clinical setting on t h e other. Nevertheless,
F r e u d does offer n u m e r o u s richly n u a n c e d descriptions of af-
fects—especially in some of h i s writing on aesthetics—even if
t h e y a r e n o t t h e centerpiece of a n y of h i s works.
There a r e two m a i n competing t e n d e n c i e s in t h e way Freud
portrays affects, a n d t h e s e two t e n d e n c i e s h a v e d o m i n a t e d the
history of psychoanalysis. According to t h e first tendency, affects
discharge energy a n d m u s t be c o m p r e h e n d e d a s t h e psychic
manifestation- (along with ideas) of drives. Closely connected to
this t e n d e n c y is t h a t , ultimately, affects h a v e their s o u r c e be-
yond t h e realm of consciousness—in t h e id. In h i s earliest writ-
ings, F r e u d developed t h e view t h a t affects discharge energy; he
t h e n modified it in t h e metapsychological p a p e r s , in particular
 Affects and Affect Regulation / 83

the essay "The Unconscious" (Freud 1915e), in order to affirm

the relation b e t w e e n drives a n d affects (and also to move a w a y
from t h e implication t h a t affects h a v e a merely pathological
function). 9 Of course, t h e shift to t h e view t h a t affects a r e t h e
manifestations of drives left F r e u d to struggle a g a i n s t t h e per-
plexing notion t h a t affects m u s t b e conscious, w h e r e a s drives
are u n c o n s c i o u s . 1 0 Although F r e u d ' s view evolved, t h e overall
direction of t h e first t e n d e n c y is to affirm t h a t affects are power-
ful, elemental biological forces.
According to t h e second tendency, affects a r e signals a n d a r e
subject—at least to s o m e degree—to t h e control of t h e ego. This
certainly carries t h e implication t h a t affects a r e regarded a s
contributing to adaptive functioning. The second tendency,
which h a s its s o u r c e in F r e u d ' s Inhibitions, Symptoms and Anxi-
ety (Freud 1926d [1925]), h a s b e e n extended further with t h e
introduction of t h e l a n g u a g e of t h e self a n d t h e concept of affect
regulation in psychoanalysis. It is fair to say t h a t t h r o u g h t h e
influence of object-relations theory a n d particularly developmen-
tal theory, t h e s e c o n d t e n d e n c y h a s flourished in r e c e n t years.
Nonetheless, t h e r e a r e some psychoanalytic t h i n k e r s , like
Andre Green, w h o w i s h to question t h e emergence of t h e second
tendency, a r g u i n g t h a t only t h e first t e n d e n c y r e p r e s e n t s a
uniquely psychoanalytic view. Green (1999) s u g g e s t s t h a t plac-
ing too m u c h i m p o r t a n c e on t h e regulatory control of ego ob-
scures t h e power of t h e u n c o n s c i o u s to g e n e r a t e affects. He also
worries a b o u t t h e diluting effect on p s y c h o a n a l y s i s of importing
ideas from biology a n d / o r developmental theory (Green 1999). In
our view, t h o u g h , t h e a s s u m p t i o n t h a t a choice m u s t b e m a d e
between t h e first a n d second t e n d e n c y is questionable. Both are
important in psychoanalysis.
Although o u r i n t e r e s t s a r e mainly consistent with t h e second
tendency, we do n o t t h i n k t h a t t h i s entails a n y slight to t h e first
one. It is i n c u m b e n t , t h o u g h , u p o n a n y o n e w h o w i s h e s to develop
the first t e n d e n c y to reformulate F r e u d ' s ideas within t h e frame-

9
There are good accounts of the development of Freud's view of affects in
Green (1999), R. Stein (1990). and Rapaport (1953).
l0
Pulver (1971) grapples with this issue and concludes that affects can be
unconscious.
84 / Theoretical Perspectives

work of c u r r e n t scientific knowledge. Consider, for example,

Green's defense of t h e first tendency, w h i c h s t r e s s e s how affects
a r e particularly oriented toward t h e inside of t h e body (1999,
p. 163). This directly follows F r e u d ' s belief t h a t t h e affect "mani-
fests itself essentially in motor (secretory, circulatory) c h a n g e s of
t h e subject's own body w i t h o u t reference to t h e outside world"
(Freud, 1915e, p. 179). O n t h e face of it, s u c h a view s e e m s to
contradict t h e psychological a n d neuroscientific views t h a t we
have e n c o u n t e r e d , which explain affects in t e r m s of r e s p o n s e s to
t h e world. It is also relevant in t h i s connection t h a t developmen-
tal r e s e a r c h h a s s h o w n t h a t infants a r e t u r n e d o u t w a r d to the
world from t h e time of b i r t h in a way t h a t d e p a r t s from the
a s s u m p t i o n s of classical psychoanalysis. (Research on t h i s topic
is d i s c u s s e d in c h a p t e r s 4 a n d 5 on infant development).
Does this m e a n t h a t we m u s t conclude t h a t F r e u d ' s intuitions
a b o u t affects are wrong? Not necessarily. It is possible to qualify
w h a t h e m e a n s by appealing to D a m a s i o ' s d i s c u s s i o n of the
"internal milieu" a n d h i s "somatic m a r k e r hypothesis," wherein
t h e b r a i n constantly m o n i t o r s w h a t is occurring in t h e body, a s a
way to u n d e r s t a n d t h e internal experience of affects. Although
t h i s m i g h t help u s characterize t h e s e n s e in w h i c h affects are
internal, it would still n o t be a negation o f t h e idea t h a t they are
s t i m u l a t e d externally. Interestingly e n o u g h , one of t h e earliest
psychoanalytic t h i n k e r s on affects, Brierley (1937), specifically
a d d r e s s e s t h i s point, urging p s y c h o a n a l y s t s to appreciate t h a t
affects c a n be either internal or external.
As a general point, it is w o r t h s t r e s s i n g t h a t psychoanalysis
h a s m u c h to gain from opening itself u p to define a n d develop
itself with reference to views from other, related fields. It is our
impression t h a t psychoanalysis h a s suffered from being isolated
from other perspectives o n t h e subject of affects. As is already
a p p a r e n t , m a n y o f t h e i s s u e s a b o u t affects t h a t have b e e n raised
within p s y c h o a n a l y s i s echo d e b a t e s from historical a n d other
perspectives.
For Freud, affects h a v e b o t h physical a n d m e n t a l aspects.
They o c c u r within t h e body, b u t t h e y h a v e psychic significance.
Like Spinoza, F r e u d defined t h e m i n d a s embodied, a n d he
articulated t h e n a t u r e of psychic experience in s u c h a way a s to
avoid t h e pitfalls of C a r t e s i a n d u a l i s m . F r e u d ' s a p p r o a c h to the
 Affects and Affect Regulation / 85

study of affects s e e k s to affirm biology without forsaking subjec-

tive experience. Although m a n y q u e s t i o n s r e m a i n unresolved
about w h a t t h i s really m e a n s , it c o n s t i t u t e s a distinctive a n d
fruitful a p p r o a c h to t h e subject. For instance, one m i g h t raise
the question of w h e t h e r t h e body is a n e c e s s a r y c o m p o n e n t of all
affective experience—or is affect experience possible w i t h o u t it?
Freud clearly appreciated t h e biological b a s i s of affects a n d s a w
them a s c o n t r i b u t i n g to survival. However, F r e u d also ascribed a
mental function to affects—for example, t h a t along with ideas,
they are t h e manifestations of drives. He implied t h a t affects play
a role in how we i n t e r p r e t a n d find m e a n i n g in t h e world,
although h e never v e n t u r e d to explore t h i s point explicitly.
Let u s t a k e a step further in formulating how psychoanalysis
follows a n d yet c a n b e distinguished from other p o i n t s of view on
affects. Insofar a s F r e u d links affects to discharge a n d t h e m a n i -
festation of drives, we m a y discern t h e Stoic orientation: affects
are strong a n d d a n g e r o u s forces t h a t a r e n o t subject to o u r
conscious control. B u t insofar a s F r e u d s e e s affects a s signals
that are subject to t h e mediation of t h e ego, a n Aristotelian
orientation is also p r e s e n t . F r e u d ' s special e m p h a s i s on t h e
single affect of anxiety m a r k s h i s view a s quite different from
Aristotle. Yet h e is certainly n o t a s s u s p i c i o u s of affects a s t h e
Stoics were. Indeed, a psychoanalytic a p p r o a c h to t h e m i n d is
often read a s challenging t h e h e g e m o n y of r e a s o n t h a t defines
the Western philosophical tradition. 1 1
Some p s y c h o a n a l y s t s , like E m d e (1983) a n d G a e n s b a u e r
(1982), explicitly register their a g r e e m e n t with t h e basic-emo-
tions view. T h e position of p s y c h o a n a l y s i s in relation to basic
emotions r e m a i n s open to question, however. O n e m i g h t note
t h a t psychoanalysis is n a t u r a l l y allied with t h e d i m e n s i o n s criti-
cism of basic emotions, given its c o m m i t m e n t to p l e a s u r e a n d
unpleasure a s basic. O n e m i g h t argue, alternatively, t h a t pleas-
ure a n d u n p l e a s u r e a r e transformed into b a s i c emotions—a
point of view t h a t is in t h e spirit of J a c o b s o n (1953). In t h i s
connection, too, it is w o r t h noting t h a t t h e r e are a n u m b e r of
psychoanalysts w h o h a v e b e c o m e interested in neuroscientific

11
Sherman (2000) offers a strong argument on this point, contrasting psy-
choanalysis with the philosophical tradition.
86 / Theoretical Perspectives

views of affects (Kaplan-Solms a n d Solms 2000; Schore 1993,

1999).
Freud c o n s t r u e s anxiety in a way t h a t e x p a n d s t h e m e a n i n g of
t h i s affect. In o n e sense, it is a l m o s t a s if he conceives of it a s
a k i n to a general s t a t e of physiological a r o u s a l . In a n o t h e r sense,
he chooses to dwell u p o n this o n e affect b e c a u s e of its clinical
prominence. T h e concern with anxiety is problematic in t h a t it
l e n d s credence to t h e notion t h a t F r e u d w a s , from t h e time of his
original u n d e r s t a n d i n g of affects a s d i s c h a r g e s of energy to his
later point of view, preoccupied with negative affect. Indeed,
J a c o b s o n (1953) w a s t h e first a n a l y s t squarely to confront t h e
fact t h a t a t t e n t i o n to t h e s a l u t a r y d i m e n s i o n of affective experi-
ence w a s m i s s i n g from F r e u d ' s theoretical a c c o u n t . Nowhere
does F r e u d grapple with t h e Aristotelian appreciation for how
affect regulation is crucial, n o t j u s t for survival, b u t for well-
being. This, is all t h e m o r e c u r i o u s in light of t h e s t r o n g interest
t h a t Freud developed in t h e affective b o n d between a n a l y s t a n d
patient.
Damasio's work is particularly relevant to p s y c h o a n a l y s i s for
a n u m b e r of r e a s o n s , s u c h a s h i s interest in t h e neurobiological
b a s i s of t h e self, especially h i s e m p h a s i s on t h e relation between
affects a n d t h e self (which coincides with t h e second t e n d e n c y in
psychoanalysis). Moreover, D a m a s i o ' s work s u p p o r t s t h e idea
t h a t we need n o t choose between w h a t we have described a s t h e
first a n d second tendencies in psychoanalytic conceptions of
affects. Damasio's c o n c e r n s r a n g e from t h e neurobiology of
m o m e n t - t o - m o m e n t internal, h o m e o s t a t i c regulation to t h e so-
phisticated integration of t h e past, p r e s e n t , a n d future autobio-
graphical self. Underlying h i s u n d e r s t a n d i n g of regulation is
biology. D a m a s i o persuasively d r a w s o u r a t t e n t i o n to t h e com-
plexity of t h e notion of regulation by d e m o n s t r a t i n g how regula-
tory p r o c e s s e s a r e n o t necessarily subject to t h e ego or self.
In t h e final section of t h i s c h a p t e r , we focus in greater d e p t h
on t h e m e a n i n g s o f t h e t e r m "regulation." For now, let u s observe
t h a t a psychoanalytic a p p r o a c h to regulation highlights t h e on-
going struggle t h a t it entails. Once achieved, regulation is not
automatically m a i n t a i n e d . Characteristically, it is lost a n d re-
gained even for t h e m o s t capable people. While it belongs to the
 Affects and Affect Regulation / 87

n a t u r e of a self to m o d u l a t e affective experience, t h i s is n o t

simply a m a t t e r of applying cognition to n a m e a n d d e t e r m i n e t h e
n a t u r e of a single affect. U n d e r s t a n d i n g regulation m e a n s heed-
ing t h e subtleties of subjective experience. More specifically, it"
m e a n s grappling with t h e elusiveness of o u r affects a n d t h e
difficulty of u n d e r s t a n d i n g their meaning. Clinical experience
m a k e s it a b u n d a n t l y evident t h a t we do n o t always k n o w how we
feel. We are often deceived a b o u t o u r affects, believing t h a t we
feel one thing, w h e n in fact it t u r n s o u t t h a t we feel s o m e t h i n g
else. Moreover, we c a n a n d often do feel different t h i n g s a t t h e
s a m e time.
Psychoanalysts h a v e a m p l e experience with t h e subjective
experience of affects. This does n o t m e a n t h a t a theory of affects
m u s t be clinically b a s e d , a s some h a v e m a i n t a i n e d (Westen
1997). It does suggest t h a t t h e basic-emotions paradigm, how-
ever n e c e s s a r y , will n o t be sufficient. Psychoanalysts are
comfortable with how u n o b v i o u s a n d complicated affective expe-
rience c a n be. Yet t h e a i m of psychoanalytic t r e a t m e n t in all
cases m u s t include t h e facilitation a n d m a i n t e n a n c e of affect
regulation. It is impossible, we think, to imagine psychoanalysis
a s not a d d r e s s i n g itself to one's relation to one's own affects.
Regulation goes to t h e very h e a r t of c h a n g e t h a t is p r o d u c e d b y
psychoanalysis.

ATTACHMENT THEORY PERSPECTIVES

It is s o m e w h a t ironic t h a t in t h e literature on a t t a c h m e n t affects

are so f u n d a m e n t a l t h a t q u e s t i o n s a b o u t w h a t they actually are
have b e e n overlooked. Affects are crucial to a t t a c h m e n t theory
b e c a u s e t h e a t t a c h m e n t relationship between infant a n d care-
giver is itself a n affective b o n d . Affect regulation h a s enjoyed,
prominence in a t t a c h m e n t theory a n d research; in fact, t h e
focus on t h i s concept c a n be u s e d a s a partial explanation of why
affects themselves h a v e n o t g a r n e r e d more specific attention.
However, t h i s explanation only goes so far. It does n o t satisfac-
88 / Theoretical Perspectives

torily explain, for example, how little Bowlby c o n c e r n e d himself

with affect a n d motivation in general. Bowlby defined a t t a c h -
m e n t in t e r m s of a n "affectional" b o n d w i t h o u t explicating w h a t
he m e a n t by t h i s t e r m . His c o m m e n t s on emotions, while high-
lighting their i m p o r t a n c e for a t t a c h m e n t , a r e n o t particularly
insightful. For example, Bowlby a s s e r t s t h a t

Many-of the most intense emotions arise during the formation,

the maintenance, the disruption and the renewal of attachment
relationships. The formation of a bond is described as falling in
love, maintaining a bond a s loving someone, and losing a part-
ner as grieving over someone. Similarly, threat of loss arouses
anxiety and actual loss gives rise to sorrow; while each of these
situations is likely to arouse anger. The unchallenged mainte-
nance of a bond is experienced as a source of security and the
renewal of a bond as a source of joy. [1980, p. 40]

His interesting idea t h a t fear is a n inevitable r e s p o n s e to certain

innately encoded stimuli—such a s novelty, s u d d e n n e s s — t h a t
triggers t h e a t t a c h m e n t system, w h e r e a s anxiety is t h e s a m e
affective r e s p o n s e once t h e a t t a c h m e n t s y s t e m h a s b e e n trig-
gered b u t n o t r e s p o n d e d to adequately by t h e caregiver, is not
strongly s u p p o r t e d by r e s e a r c h . There is n o indication t h a t
Bowlby fully appreciated how affect regulation e n s u e s from at-
t a c h m e n t . Happily, t h e t e n d e n c y i n r e c e n t a t t a c h m e n t w o r k is to
pay more attention to affects in relation to affect regulation, a n d
so we t u r n now to examine t h i s development.
In a t t a c h m e n t theory, t h e regulation of affects serves to foster
t h e emergence of self-regulation from coregulation. Or, p u t into
t h e alternative language t h a t Sroufe u s e s , t h i s m e a n s t h a t
t h e regulatory s y s t e m of t h e infant is transformed from being
"dyadic" to being "individual." Sroufe's focus is o n t h e role of
emotions in development. He observes t h a t Bowlby did not
adequately conceptualize affects, a n d therefore h e u n d e r t a k e s
this t a s k (Sroufe 1996, p. 177). He m a i n t a i n s t h a t emotions
arise d u r i n g t h e second half of t h e first year of life. To some
extent, t h i s offers a challenge to t h e basic-emotions position.
Sroufe specifically rejects t h e view p u t forth by Izard t h a t infants
a r e b o r n with b a s i c emotions, s t r e s s i n g i n s t e a d t h a t s u c h emo-
 Affects and Affect Regulation / 89

tions come into being t h r o u g h t h e i n p u t of a caregiver. Sroufe's

point is t h a t emotions exist from b i r t h only in a p r e c u r s o r form;
a shift t h e n o c c u r s d u r i n g t h e second half-year of life whereby
emotions b e c o m e m o r e differentiated a n d less global. E m o t i o n s
are thereby experienced subjectively a n d are i m b u e d with m e a n -
ing in a n e w s e n s e . As Sroufe claims, d u r i n g t h e second half of
the first year, "regulation of a r o u s a l a n d emotion no longer
depend simply on w h a t t h e caregiver does, b u t on how t h e infant
interprets t h e caregiver's accessibility a n d behavior" (p. 170).
Sroufe g r o u n d s h i s notion of affect regulation in t h e capacity
to m a i n t a i n organization in t h e face of tension. He is careful to
emphasize t h a t t h i s is n o t a m a t t e r of cognition influencing
affects. Sroufe m a k e s t h e proposal t h a t t h e regulation of affects
ought to be s e e n a s a n "Anlage" or prototype of self-regulation.
Self-regulation is u n d e r s t o o d a s p a r t of a n e x u s t h a t includes
self-reliance a n d self-esteem. Sroufe t r a c e s t h e m o v e m e n t of how
"confidence in t h e caregiver b e c o m e s confidence in t h e self with
t h e caregiver a n d , ultimately, confidence in t h e s e l f (1996,
p. 186). Although Sroufe would seem to be receptive to p o s t u l a t -
ing intrapsychic s t r u c t u r e s t h a t a r e p r o d u c e d by a t t a c h m e n t —
given t h a t h e w a s responsible for t h e shift away from Bowlby's
notion t h a t t h e goal of a t t a c h m e n t is proximity to t h e caregiver to
the goal of "felt security" (Sroufe a n d W a t e r s 1977a)—he does n o t
attempt to articulate w h a t u n d e r l i e s t h e idea of self-confidence.
Another a t t a c h m e n t t h e o r i s t w h o s e w o r k h a s focused o n t h e
role of affects is Magai (1999). (For h e r earlier work on t h i s topic,
published u n d e r t h e n a m e Malatesta, see Malatesta, Culver,
Tesman, a n d S h e p a r d 1989.) Like Sroufe, Magai acknowledges
t h a t Bowlby did n o t pay m u c h a t t e n t i o n to affects themselves.
Nevertheless, s h e p o i n t s o u t some similarities between Bowlby
and Tomkins, w h o developed their respective views a t a r o u n d
the s a m e time. Although Magai is m o r e s y m p a t h e t i c t h a n Sroufe
to the b a s i c - e m o t i o n s position, h e r special interest lies in how
parental affective style influences t h e capacity for regulation.
A key a s p e c t of Magai's work is d r a w n from Cassidy, who
proposes a connection between styles of a t t a c h m e n t a n d regula-
tion. Yet, to h e r credit, Magai cautiously resists t h e supposition
t h a t emotional t r a i t s / d i s p o s i t i o n s completely overlap with at-
t a c h m e n t style.
 90 / Theoretical Perspectives

According to Cassidy, affect regulation c a n be linked to t h e

quality of a t t a c h m e n t (1994, p. 247). T h e a n x i o u s / a v o i d a n t style
of a t t a c h m e n t t e n d s to minimize affects a n d t h u s c a n be u n d e r -
stood in t e r m s of t h e overregulation of affect; t h e a n x i o u s /
ambivalent style t e n d s to h e i g h t e n affects a n d t h u s c a n be
u n d e r s t o o d in t e r m s of t h e u n d e r r e g u l a t i o n of affect. T h e s e c u r e
style of a t t a c h m e n t manifests a n open a n d flexible kind of regu-
lation. More specifically, Cassidy m a i n t a i n s t h a t in a n x i o u s /
avoidant a t t a c h m e n t , t h e aversion to negative affect m e a n s t h a t
negative affect is n o t expressed, b u t n o t t h a t it is n o t felt.
In a n x i o u s / a m b i v a l e n t a t t a c h m e n t , it is u n c l e a r w h e t h e r t h e
greater r e s p o n s i v e n e s s to negative affect m e a n s t h a t it is ex-
pressed to a degree beyond h o w it is actually felt. Cassidy's work
offers a promising way to t h i n k a b o u t affective experience
for a t t a c h m e n t theory a n d h a s b e e n developed further by Slade
(1999), who s u g g e s t s how p r o b l e m s in dysregulation c a n be tied
to various types of pathology.
As a t t a c h m e n t theory h a s evolved, so t h e concept of affect
regulation h a s become increasingly central. Interest in affects
themselves h a s b e e n slower to evolve a n d is still in t h e p r o c e s s of
developing. There is clearly a n Aristotelian bias in a t t a c h m e n t
thinking a b o u t affects—they are, by n a t u r e , u n d e r s t o o d to be
subject to modulation. There is n o t m u c h evidence t h a t a t t a c h -
m e n t theorists give m u c h credence to t h e Stoic orientation to
affects. Indeed, a t t a c h m e n t theorists have n o t c o n t e n d e d with
t h e first s y s t e m of emotional r e s p o n s e a s depicted by LeDoux
a n d s u p p o r t e d by Damasio. Hofer's (1984, 1990; Polan a n d Hofer
1999) work with r a t p u p s a n d m o t h e r s comes closest to doing so,
a s it offers a n a c c o u n t of regulation t h r o u g h a t t a c h m e n t t h a t
e m p h a s i z e s h i d d e n d i m e n s i o n s t h a t are n o t subject to c o n s c i o u s
control. Hofer w a r n s u s , in fact, t h a t regulation should n o t be
conceived of strictly in t e r m s of affects.
There c o n t i n u e to be differences a m o n g a t t a c h m e n t theorists
in t h e way t h e y t h i n k a b o u t affects. S o m e are m o r e explicitly
sympathetic to t h e basic-emotions position t h a n a r e o t h e r s . A
n u m b e r of a t t a c h m e n t theorists have come to a d o p t w h a t is
referred to a s a "functionalist" position. This emphasizes, n o t
j u s t t h a t affects themselves a r e regarded a s subject to regula-
tion, b u t t h a t t h e y serve a s regulators a s well (N. Fox 1994).
 Affects and Affect Regulation / 91

Others have tried to articulate a s y s t e m s point of view t h a t

features t h e i n t e r d e p e n d e n c e of all p r o c e s s e s (Fogel 1993; Lewis
and Granic 2000). W h a t a t t a c h m e n t theorists a n d r e s e a r c h e r s
s h a r e is a c o m m i t m e n t to follow o u t in development h o w affec-
tive experience c o n t r i b u t e s to t h e acquisition of self-regulation
t h r o u g h coregulation between caregiver a n d infant.
A problem a r e a in a t t a c h m e n t theory t h a t b e a r s on t h e topic
of affects a n d affect regulation h a s b e e n its conception of internal
structure, or w h a t is t e r m e d t h e "internal working models."
Initially, t h e idea of working models w a s u n d e r s t o o d in a way
t h a t w a s close to being a reduplication of external interaction.
Mary Main (1991) r e n d e r e d t h e idea of working models more
complex with h e r e m p h a s i s on metacognition—the higher-order
capacity to a p p r a i s e a n d reorganize memories. T h e notion of
internal s t r u c t u r e is developed even further in s u b s e q u e n t c h a p -
ters with t h e i d e a s of mentalization, a n d particularly t h e unfold-
ing of t h e capacity for mentalization. From t h e s a m e epistemic
tradition, t h i s volume a i m s to m a k e a contribution to t h e re-
conceptualization of a t t a c h m e n t theory beyond Bowlby's notion
of proximity to t h e caregiver a n d Sroufe a n d Water's (1977a)
important qualification of "felt security." In t h e following c h a p t e r
(chapter 3) we a t t e m p t to s h o w t h a t t h e realm of r e p r e s e n t a t i o n
is not merely derived from, b u t constitutive of, t h e evolution of
a t t a c h m e n t . MacLean's (1990, 1993) theory o f t h e t r i u n e brain,
which d i s t i n g u i s h e s t h r e e s t a g e s of t h e b r a i n ' s evolution—the
reptilian, p a l e o m a m m a l i a n , a n d n e o m a m m a l i a n — m i g h t be u s e -
fully applied to t h e difference between Bowlby's idea of proximity
to t h e caregiver (which c a n be associated with t h e p a l e o m a m -
malian brain) a n d o u r focus on mentalization or reflective func-
tion (which c a n b e associated with t h e n e o m a m m a l i a n brain). 1 2
In the next section, we elaborate on t h e impact of reflective
function on affective experience, i n t r o d u c i n g a n e w term—
"mentalized affectivity"—to characterize this. In conclusion,

12
MacLean observes that the paleomammalian brain is distinguished by the
separation cry, the most primitive and basic mammalian vocalization; the
neomammalian brain is produced through expanded memory and intelligence.
MacLean's theory of the "triune brain," while provocative, has not been univer-
sally accepted. See, for example, Pinker's (1997) criticism of it.
92 / Theoretical Perspectives

a t t a c h m e n t theorists have m a d e progress in focusing on affects

themselves, t h o u g h some of t h e t e n s i o n s between affects a n d
affect regulation deserve greater exploration.

AN INTEGRATED PERSPECTIVE
ON AFFECTS A N D AFFECT REGULATION

In this concluding section, we s h a r p e n o u r d i s c u s s i o n of the

relation between psychoanalysis a n d a t t a c h m e n t theory on the
subject of affects a n d affect regulation, leading u s to reconsider
t h e m e a n i n g of affect regulation a n d to reflect u p o n t h e closely
related concepts of seUvregulation a n d mentalization. Finally,
we move on to i n t r o d u c e t h e notion of "mentalized affectivity,"
t h e a d u l t capacity to regulate affects, w h i c h will be d i s c u s s e d
more fully in c h a p t e r 11 in connection with clinical material.
Psychoanalysis a n d a t t a c h m e n t theory dovetail in their depic-
tion of t h e i m p o r t a n t role played by affect regulation in early
development, in facilitating t h e emergence of t h e s e n s e of self
a n d t h e transformation of coregulation to self-regulation. Both
perspectives also c o n c u r in u n d e r s t a n d i n g affect regulation a s a
b a l a n c e between positive a n d negative affect; in particular, they
u p h o l d t h e value of negative affect a s opposed to a s s u m i n g t h a t
it o u g h t to be expunged. Yet, s o m e t e n s i o n s between psycho-
a n a l y s i s a n d a t t a c h m e n t theory have b e e n uncovered a s well (for
a c o n c e p t u a l review see Fonagy 2001). Classical psychoanalysis
views affects a s connected with drives, a n d even in m o r e contem-
porary versions of psychoanalysis t h e r e r e m a i n s a n affinity with
t h e notion t h a t affects are powerful, primitive forces. Insofar a s
affects a r e located in bodily experience, it m a k e s s e n s e t h a t there
will b e limits to o u r a w a r e n e s s of t h e m . A t t a c h m e n t theory, in
c o n t r a s t , d i s t a n c e s itself from t h i s w a y of t h i n k i n g a b o u t affects.
Affects are regarded a s adaptive, a n d , moreover, affect regulation
e n s u r e s t h a t t h i s is t h e case.
It is t e m p t i n g to conclude t h a t while affects have primacy for
psychoanalysts, affect regulation is c h e r i s h e d for a t t a c h m e n t
theorists. However, it would be a m i s t a k e to ignore t h e fact t h a t
affect regulation is i m p o r t a n t in p s y c h o a n a l y s i s a s well. As al-
 Affects and Affect Regulation / 93

ready d i s c u s s e d , affect regulation in psychoanalysis is a concept

with distinct c o n n o t a t i o n s of struggle. It is subject, a s every
mental activity is, to t h e inherently conflictual n a t u r e of
the mind: c o n s c i o u s experience is b o u n d to r u n u p a g a i n s t t h e
u n c o n s c i o u s . Affect regulation in a t t a c h m e n t theory is conceived
of more optimistically: s e c u r e a t t a c h m e n t m e a n s t h a t affect
regulation c a n work well—that is, flexibly a n d reliably. Of course,
a t t a c h m e n t theory envisions less desirable forms of regulation
(or dysregulation) in i n s e c u r e a t t a c h m e n t . Still, t h e r e is a differ-
ence between p s y c h o a n a l y s i s a n d a t t a c h m e n t theory in how
affect regulation is u n d e r s t o o d .
The t e n s i o n between how affect regulation is u n d e r s t o o d in
psychoanalysis a n d a t t a c h m e n t theory reflects a larger confu-
sion a b o u t t h e m e a n i n g of t h e concept. As a term, affect regula-
tion is u s e d in n u m e r o u s s e n s e s a n d w i t h o u t m u c h precision.
Recent a t t e m p t s in psychology to clarify t h e meaning(s) of affect
regulation deserve o u r attention. G r o s s (1999) offers t h e defini-
tion of affect regulation a s "processes by which individuals in-
fluence w h i c h emotions t h e y have, w h e n t h e y have them, a n d
how t h e y experience a n d e x p r e s s t h e s e emotions" (p. 275). He
endorses a "process-oriented a p p r o a c h " in w h i c h affect regula-
tion e m b r a c e s s i t u a t i o n selection, situation modification, atten-
tion deployment, cognitive change, a n d r e s p o n s e modulation.
Underlying Gross's point of view is a n evolutionary perspective
that c o n s t r u e s emotions a s "flexible r e s p o n s e systems." The
sources of affect regulation lie in b o t h psychoanalysis a n d t h e
stress a n d coping tradition, b o t h of which, according to him,
emphasize t h e r e d u c t i o n of negative affect. Gross claims, on t h e
contrary, t h a t affect regulation o u g h t to include increasing, de-
creasing, a n d m a i n t a i n i n g positive a n d negative affect. He also
argues t h a t affect regulation is b e s t restricted to one's own
relation to one's affects, r a t h e r t h a n how one influences others'
affects (how others' influence one's affects is n o t mentioned).
Gross fails to t a k e seriously t h e developmental ideas we h a v e
considered, w h e r e i n t h e infant's own affective experience is de-
termined by t h e interaction between himself a n d t h e primary
caregiver.
Anticipating Gross, Ross T h o m p s o n (1990, 1994) a t t e m p t s to
grapple with t h e lack of a clear definition of affect regulation. He
94 / Theoretical Perspectives

claims t h a t we o u g h t to t h i n k of affect regulation a s "heterogene-

ous," n o t a s a "unitary p h e n o m e n o n . " Nevertheless, T h o m p s o n
moves on to formulate a definition t h a t e n c o m p a s s e s all of its
m a n y aspects. According to T h o m p s o n , affect regulation "con-
s i s t s of t h e extrinsic a n d intrinsic p r o c e s s e s responsible for
monitoring, evaluating a n d modifying emotional reactions, espe-
cially their intensive a n d temporal features, to accomplish one's
goals" (1994, pp. 27-28). Affect regulation serves adaptive p u r -
poses a n d , a s T h o m p s o n m a k e s clear, is closely connected
to socialization. T h o m p s o n ' s s y m p a t h i e s for a t t a c h m e n t theory
m e a n t h a t h e is n o t willing to d e t a c h t h e i s s u e of one's own
relation to one's own affects from t h e i s s u e of others' relation to
one's affects.
At t h e c e n t e r of T h o m p s o n ' s investigation is a n e n u m e r a t i o n
of t h e various objects of affect regulation: (a) neurophysiological
p r o c e s s e s underlying emotional a r o u s a l a n d its m a n a g e m e n t , (b)
attention processes, (c) informational p r o c e s s e s — s u c h a s t h e
reinterpretation of events (which is linked to defense m e c h a -
nisms), (d) encoding of internal cues, s u c h a s of t h e internal
indicators of emotional arousal, (e) e n h a n c i n g a c c e s s to coping
m e c h a n i s m s , (/) helping to predict a n d control commonly en-
c o u n t e r e d settings, a n d [g] expressing emotions in a satisfactory
way—that is, c o n c o r d a n t with one's p e r s o n a l goals for t h e situa-
tion. This comprehensive list conveys t h e b r o a d r a n g e of a i m s
t h a t coincide with affect regulation—from t h e neurobiological
b a s i s of regulation to its role in successful a d a p t a t i o n to the
social world. Although T h o m p s o n acknowledges a n internal di-
m e n s i o n of affect regulation {d above), h i s explanation focuses
on experiences like t h e reinterpretation of rapid h e a r t rate,
b r e a t h i n g rate, a n d / o r perspiration. T h e example h e provides
c o n c e r n s a n actor who m a n a g e s stage fright by reinterpreting
emotional a r o u s a l to signify t h e expected anticipation of public
performance, r a t h e r t h a n i m p e n d i n g dysfunction. T h o m p s o n ' s
u n d e r s t a n d i n g of t h e internal d i m e n s i o n of affect regulation is
insightful, a s it u n d e r s c o r e s t h a t t h e concept s h o u l d n o t be
limited to its manifestation in action. Yet, a s we will show,
T h o m p s o n does n o t go far e n o u g h in c a p t u r i n g affect regulation
viewed t h r o u g h t h e lens of mentalization.
 Affects and Affect Regulation / 95

O u r contribution to t h e project of clarifying t h e concept of

affect regulation consolidates t h e earlier perspectives t h a t have
been d i s c u s s e d with t h e views p r e s e n t e d above. At t h e lowest
level of regulation, we m u s t t h i n k of t h e organism's equilibrium,
to which n e u r o s c i e n t i s t s like D a m a s i o a n d psychobiologists like
Hofer h a v e d r a w n o u r attention. O n t h i s level, affect regulation is
equivalent to h o m e o s t a s i s ; it o c c u r s approximately a n d largely
outside c o n s c i o u s a w a r e n e s s . Regulation p r o m p t s u s to alter o u r
state a n d to a c t expeditiously in c i r c u m s t a n c e s where t h i s is
n e c e s s a r y — s u c h a s extreme s i t u a t i o n s in w h i c h survival is a t
stake. Choice c a n become p a r t of t h i s level of affect regulation,
although t h e e n s u i n g action c a n be s p o n t a n e o u s a n d w i t h o u t
accompanying reflection.
On a n o t h e r level, regulation o c c u r s in connection with o u r
relation to o t h e r s . Regulation serves to help u s to craft affects
and to c o m m u n i c a t e t h e m (at t i m e s in lieu of acting on them).
Indeed, a t t h i s level, we a r e moving to deal with self-regulation a s
m u c h a s affect regulation. Affect regulation c o n c e r n s t h e regula-
tion of affects, b u t it h a s implications for t h e self since it helps to
bring t h e self into existence (see Gergely a n d W a t s o n 1996, a n d
chapter 4). Self-regulation o c c u r s w h e n t h e object of regulation is
the self; t h i s c a n be, b u t is n o t necessarily, achieved t h r o u g h
affects. In o n e sense, self-regulation c a n b e considered a s a
higher kind of affect regulation; in a n o t h e r sense, it c o n s t i t u t e s
a change in form. In order to clarify t h e c h a n g e t h a t t a k e s place
between affect regulation a n d self-regulation, it will be n e c e s s a r y
to say more a b o u t w h a t it m e a n s to be a self.
Affect regulation on t h e second level is a b o u t t h e m e a n i n g
t h a t affects h a v e for p a r t i c u l a r individuals. Insofar a s regulation
involves t h e capacity to r e m a i n within a n affective s t a t e a s one
considers it, we h a v e a different model from t h o s e found tradi-
tionally in philosophy a n d psychology, w h e r e i n cognition a c t s
u p o n t h e affect. A p r e c e d e n t for w h a t we have in mind h e r e is
found in Spinoza: while h e s t r e s s e s t h e u s e of r e a s o n over t h e
affect, he e m p h a s i z e s t h e value of allowing t h e affect to be felt for
self-understanding. Like others, we appreciate t h a t t h e r e m u s t
be a cognitive c o n t r i b u t i o n to regulation—whether this is c a s t in
t e r m s of a p p r a i s a l , attention, or informational processing—but
 96 / Theoretical Perspectives

we wish to posit t h e distinctive possibility of doing so while

preserving t h e affective state. The s t a t e might b e adjusted up-
w a r d (increased) or downward (decreased), a n d it m i g h t n o t be
altered a t all.
O u r point is certainly n o t to challenge the possibility of affect
regulation leading to o u t w a r d action. O u r intention is merely to
d r a w attention to a specific function of affect regulation t h a t is
predicated u p o n mentalization a n d t h a t h a s n o t b e e n described
in t h e literature on regulation. Mentalization is t h e larger cat-
egory t h a t includes self-regulation. Like self-regulation, reflective
function does n o t necessarily c o n c e r n affects. However, insofar
a s it does concern affects, affective experience will b e processed
in a more complex way. J u s t a s reflective function b r i n g s a b o u t a
new kind of interest in one's own m i n d , mentalization with
affects brings a b o u t a n e w kind of relation to one's own affects.
Let u s try to distinguish a n d label t h i s u l t i m a t e form of affect
regulation. T h e concept of "mentalized affectivity" m a r k s a n
a d u l t capacity for affect regulation in w h i c h o n e is c o n s c i o u s of
one's affects, while r e m a i n i n g within t h e affective s t a t e . S u c h
affectivity d e n o t e s t h e capacity to fathom t h e meaning(s) of
one's own affect states. This is a goal t h a t is n o less significant,
evolutionarily speaking, t h a n is t h e goal of acting u p o n one's
emotions. It is w o r t h noting h o w close t h e notion of mentalized
affectivity is to w h a t h a p p e n s in psychoanalytic (and other k i n d s
of) psychotherapy. It is widely appreciated by clinicians t h a t it is
crucial to u n d e r s t a n d one's own feelings experientially in a way
t h a t is emotionally meaningful (vs. intellectually). There is a n
especially deep appreciation in p s y c h o a n a l y s i s for how difficult it
c a n be to u n d e r s t a n d one's own affective s t a t e s a n d experiences.
Not only do we m i s u n d e r s t a n d w h a t we feel, t h i n k i n g t h a t we
feel one t h i n g while we really feel a n o t h e r emotion; b u t we often
feel more t h a n o n e emotion, even contradictory emotions, a t the
s a m e time. Mentalized affectivity enables u s to be h u m a n — o r ,
ironically put, to b e c o m e even m o r e h u m a n .
 The Behavior Geneticist's Challenge
to a Psychosocial Model
of t h e D e v e l o p m e n t of Mentalization

In this chapter, we consider t h e r e c e n t challenges to t h e psycho-

social a p p r o a c h t a k e n in t h i s book. T h e a s s u m p t i o n t h a t t h e
quality of mentalizing is related to t h e quality of early object
relations is a c o m m o n t h r e a d t h r o u g h o u t t h e volume. We a r g u e
t h a t m a n y of t h e k n o w n c o n s e q u e n c e s of sensitive a s opposed to
neglecting a n d m a l t r e a t i n g early e n v i r o n m e n t s m i g h t be u n d e r -
stood a s having a n i m p a c t on t h e child's capacity to mentalize.
However, s u c h a s s u m p t i o n s concerning t h e influence of t h e
child's family e n v i r o n m e n t h a v e recently b e e n challenged by
evidence from behavior genetics. Findings from s t u d i e s of twins
and from children a d o p t e d early in life are u s e d to claim t h a t
past work h a s exaggerated t h e influence of p a r e n t i n g on child
development. If s u b s t a n t i a t e d , t h e s e critiques would remove t h e
logical foundation of m o s t p s y c h o d y n a m i c or psychoanalytic a p -
proaches, r e n d e r i n g t h e p r e s e n t proposals, a m o n g others, u n -
tenable.
It is therefore i n c u m b e n t u p o n u s to review t h e s e critiques
and to a t t e m p t a vigorous defense of t h e environmentalist posi-
tion. In t h e c o u r s e of t h i s defense, we will a r g u e t h a t t h e role of
early experience is critical in determining gene expression a n d
t h a t t h e influence of early environment, a s a m o d e r a t o r of t h e
progress from genotypic potential to phenotypic outcome, m a y

97
 98 / Theoretical Perspectives

therefore be very s u b s t a n t i a l . We place mentalization a t the

h e a r t of this p r o c e s s of moderation, a r g u i n g t h a t t h e interpreta-
tion of t h e environment r a t h e r t h a n t h e a c t u a l environment
governs genetic expression. T h e s e c o n s i d e r a t i o n s lead u s to re-
formulate t h e influence of a t t a c h m e n t on later development.
Moving from a model where t h e early relationship w a s seen a s
offering a template for later relationships—a model t h a t a p p e a r s
naive in t h e light of m o r e r e c e n t evidence—we a r g u e t h a t it is the
quality or "depth of processing" of t h e psychosocial environment
t h a t c a n be set by early experience. We posit t h a t t h e evolution-
ary function of t h e early relationship might indeed be to equip
t h e child with t h e mentalizing skills n e c e s s a r y to function effec-
tively in a stressful social world. Insecurity in a t t a c h m e n t rela-
tionship m a y be a signal of some limitation in mentalizing skills.
T h e self-representation is t h e n n o t so r o b u s t to social relation-
ships, a n d t h e child or a d u l t n e e d s special strategies to cope
with intimate interpersonal relations. We recognize t h e s e strate-
gies a s t h e c o m m o n types of insecurity: t h e avoidant or dismiss-
ing strategy on t h e one h a n d , a n d t h e r e s i s t a n t or preoccupied
strategy on t h e other. T h e complete failure of mentalization is no
longer characterized by a clear a t t a c h m e n t strategy. Disorgani-
zation of a t t a c h m e n t m a y be t h e indication of exceptionally poor
mentalization.

INTRODUCTION

Over t h e p a s t t e n y e a r s we—developmental professionals a s well

a s t h e lay public—have u n c o n s c i o u s l y switched from a primarily
psychosocial model of child a n d a d u l t development to a genetic-
biological frame of reference t h a t often a priori excludes consid-
eration of c h i l d - p a r e n t relationships. In a n informal s t u d y , we
a s k e d twenty p a r e n t s referred to a n o u t p a t i e n t child c o m m u n i t y
m e n t a l h e a l t h clinic consecutively a b o u t t h e likely c a u s e of their
child's problems. It s u r p r i s e d n o one t h a t t h e y all p u t brain
chemistry a t t h e top of t h e list. It w a s m o r e s u r p r i s i n g t h a t "bad
genes" came second, p e e r s third, a n d early life experiences a
poor fifth, j u s t a h e a d of food additives. Why is t h i s h a p p e n i n g ?

it
 A Psychosocial Model ofthe Development of Mentalization / 99

The excitement of novelty, of scientific discovery, m u s t have

something to do with it. B u t t h i s is n o t a sufficient explanation.
The reduction of t h e m i n d to a genetically prefigured constella-
tion of b r a i n chemicals is appealing. While o u r c o n s c i o u s n e s s ,
our free will, o u r m i n d is u n d o u b t e d l y o u r m o s t t r e a s u r e d pos-
session, it is also t h e s o u r c e of all o u r s a d n e s s , conflict, pain,
suffering, a n d misery. The reduction of models of pathology to a
principally genetic m o d e of c a u s a t i o n is u n d o u b t e d l y a relatively
comfortable solution for all of u s — b u t like all comforts, it comes
at a price.
A fault line r u n s t h r o u g h m o d e r n developmental psychopa-
thology. E n v i r o n m e n t a l e n t h u s i a s t s , s u c h a s t h e a u t h o r s of this
volume, c o n t i n u e to p u r s u e their a g e n d a of identifying key social-
izing p r o c e s s e s in development with a view to designing ever-
improved psychosocial t r e a t m e n t a n d prevention strategies. They
work (in a t t a c h m e n t r e s e a r c h , for instance), apparently oblivious
to the work of behavior a n d molecular geneticists (the new
nativists), w h o h a v e in t h e m e a n t i m e settled t h e entire i s s u e of
developmental c a u s a t i o n , a t least in principle, a n d a r e b u s y
trying to find t h e g e n e s a n d p r o t e i n s to explain pathological b r a i n
development. T h o s e w h o try to bridge t h e gap—Michael Rutter
(Rutter, Silberg, O'Connor, a n d Simonoff 1999a, 1999b), David
Reiss (Reiss, Neiderhiser, Hetherington, a n d Plomin 2000),
Robert Plomin (Plomin, Fulker, Corley, a n d DeFries 1997)—are
relatively few in n u m b e r . As p a i d - u p m e m b e r s of t h e gradually
thinning g r o u p of environmental e n t h u s i a s t s , we, too, are trying
to forge links, while r e m a i n i n g quite a w a r e of w h a t h a p p e n s to
those who try to build bridges a c r o s s fault lines.
Where h a s all t h e mystery gone? Recently, one of u s s a w
three new m a l e c a s e s on t h e s a m e day. They were very different:
a depressed j o u r n a l i s t with sexual problems, a y o u n g m a n soon
to be married b u t worried a b o u t h i s history of bipolar illness,
and a n adolescent with violent behavior problems. During initial
a s s e s s m e n t s it is interesting to try to elicit t h e patients' theory of
their problems a n d a s k s o m e t h i n g like: "Why do you t h i n k this
h a s h a p p e n e d to you?" of "Why do you t h i n k people like you get
depressed?" O n t h i s p a r t i c u l a r day, surprisingly, all t h r e e m e n
came u p with identical a n s w e r s : "I t h i n k from m y m o t h e r I
inherited a t e n d e n c y to look for t h e negative," said t h e journalist;
 100 / Theoretical Perspectives

"I t h i n k it is well established to be a chemical i m b a l a n c e c a u s e d

by m y genes," said t h e groom with t h e bipolar disorder; a n d "I've
b e e n told I have b a d g e n e s t h a t m a k e m e hit people," replied t h e
adolescent.
In e a c h case, a s they answered, time seemed to collapse.
There w a s n o s p a c e between t h e m o m e n t t h e i r father's s p e r m
p e n e t r a t e d their m o t h e r ' s o v u m a n d t h e p r e s e n t m o m e n t . Of
course, in e a c h case it w a s possible to call u p o n t h e n a t u r a l
h u m a n desire to create a meaningful life narrative a n d to explore
how their experiences h a d a s s i s t e d or h i n d e r e d their capacity to
cope with t h e difficulties t h e y b r o u g h t . P s y c h o t h e r a p y is b a s e d
on biological forces t h a t a r e rooted m o r e deeply t h a n a n y intel-
lectual conviction a b o u t the origin of a p a t i e n t ' s difficulties. But
while t h e y e x p o u n d e d their respective naive nativist views, t h e r e
w a s n o room for dialogue. There w a s j u s t o n e simple m e s s a g e :
Don't a s k w h a t c a u s e s m y problems, don't probe m y memories
or t h o u g h t s or feelings; t h e r e is n o t h i n g to know, t h e a n s w e r lies
in m y genes. There w a s n o room for h u m a n mystery! This
inability to envision psychological a n d psychosocial c a u s a t i o n is
b o t h a t t h e root of t h e psychological p r o b l e m s t h e s e individuals
b r o u g h t into t h e consulting-room a n d a t t h e core of t h e naive
nativist perspective.

THE DEMISE OF SOCIALIZATION:

PARENTING V E R S U S GENETICS

There are t h r e e p r i m a r y a g e n t s of socialization of children in

Western society: families, peer groups, a n d day-care c e n t e r s or
schools (Maccoby 2000). T h e e m p h a s i s , b o t h professional a n d
cultural, h a s b e e n on t h e family a s a n a g e n t of socialization. For
t h e b e s t p a r t of t h e p a s t century, b o t h psychological theories
(e.g., Alexander a n d P a r s o n s 1982; Bowlby 1958; P a t t e r s o n
1976; Winnicott 1963) a n d c o m m o n s e n s e psychological views
(Leach 1997; Spock a n d Rothenberg 1985) agreed in Identifying
experience with p a r e n t s a s pivotal in s h a p i n g a n individual's
values, beliefs, c h a r a c t e r , a n d , naturally, dysfunctions in a d a p -
tation. It is interesting to note that, of t h e two psychological
 A Psychosocial Modelofthe Development of Mentalization / 101

approaches—learning theory a n d p s y c h o a n a l y s i s — t h a t domi-

nated t h e l a s t century, it w a s t h e latter t h a t retained some
e m p h a s i s on t h e constitutional delimiters to socialization (e.g.,
Freud 1 9 1 2 - 1 3 , 1920g; Neu 1992).
The l a s t q u a r t e r of t h e twentieth c e n t u r y s a w a d r a m a t i c
realignment of developmental theories. T h e emergence of a cog-
nitive m e n t a l science (e.g., B a r a s a l o u 1991; J o h n s o n - L a i r d 1983)
prompted t h e t r a n s l a t i o n of s o m e learning a n d m a n y psycho-
dynamic principles into t h e l a n g u a g e of information processing,
with p r e s u m e d m e n t a l o p e r a t i o n s on p a s t experience creating
predictable b i a s e s a n d distortions (what u s e d to be called
psychic defenses) in m e n t a l r e p r e s e n t a t i o n s (e.g., B a n d u r a 1977;
Mischel 1973). Cognitive behavioral a p p r o a c h e s to development
a n d psychopathology were ultimately saved from tautology a n d
circularity by two factors: (a) t h e theory inspired a whole series of
brief a n d effective psychosocial interventions (cognitive behav-
ioral therapy—e.g., Beck 1976; M e i c h e n b a u m 1997); a n d (b) t h e
introduction of a dialectical model into developmental theory
(e.g., C h e s s a n d T h o m a s 1979; Kagan 1989).
The views of socialization t h a t emerged from cognitive social
learning theory h a v e u n d e r s c o r e d t h a t t h e child plays a n im-
p o r t a n t role in d e t e r m i n i n g h i s own socialization experience.
Clearly, m o t h e r i n g a n infant high in emotionality m u s t elicit
quite a different set of m a t e r n a l behaviors t h a n would t h e
mothering of a sociable, u n e m o t i o n a l infant. This realization w a s
critical in radically a n d helpfully m o d e r a t i n g t h e p a r e n t - b l a m i n g
tendency of early psychopathologists. Although t h e s e t r a n s a c -
tional models of child-to-parent effects were later u s e d to s u p p o r t
the a r g u m e n t of t h o s e proposing a nativist revival, for t h e m o s t
part cognitive social learning theory m a i n t a i n e d t h e environmen-
talist tradition of psychoanalytic theories. The s i m u l t a n e o u s in-
d e p e n d e n t emergence in t h e late 1960s of t h e family s y s t e m s
perspective (e.g., M i n u c h i n et al. 1975) a n d Bronfenbrenner's
(1979) influential ecological ideas in t h e 1970s increased t h e
explanatory power of socialization a n d further reinforced t h e
focus of developmentalists on t h e social environment.
Developmental psychopathology, p e r m e a t e d with t h e dialectic
of social l e a r n i n g theory, c a m e to d o m i n a t e child psychiatric
epidemiology, u n d e r t h e leadership of N o r m a n Garmezy, with
 102 / Theoretical Perspectives

other giants s u c h a s Michael Rutter, Alan Sroufe, Robert Emde,

a n d D a n t e Cicchetti. T h e key r e s e a r c h question c a m e to be t h e
mysterious unfolding, integration, a n d interaction of p e r s o n a n d
environmental characteristics in t h e generation of psychological
d i s t u r b a n c e t h r o u g h ontogenetic development. Notwithstanding
t h e explicit c o m m i t m e n t to a dialectic t r a n s a c t i o n a l model (e.g.,
Garmezy, Masten, a n d Tellegen 1984), developmental psycho-
pathology always retained its e m p h a s i s on socialization, p a r -
ticularly intrafamilial socialization (e.g., Cicchetti 1987; Rutter
1993; Sameroff 1995). A t t a c h m e n t theory b e c a m e o n e of t h e
guiding frameworks of t h e a p p r o a c h (e.g., C i c c h e t t i a n d Cohen
1995; Sroufe a n d R u t t e r 1984), a n d J o h n Bowlby w a s , to some
degree p o s t h u m o u s l y , recognized by m a n y a s o n e of its pioneers
(Sroufe 1986). T h u s , n o t w i t h s t a n d i n g t h e d o m i n a n c e of cognitive
psychology a n d social learning theory, developmental psycho-
pathology r e m a i n e d a broad c h u r c h , a n d m a n y p s y c h o d y n a m i c
concerns—in p a r t i c u l a r a focus on early relationships (e.g.,
Cicchetti 1987), on affect regulation (e.g., Sroufe 1996), on rela-
tionship r e p r e s e n t a t i o n s (e.g., Dodge 1990), a n d on p r o c e s s e s
of identification (e.g., Crittenden 1994), internalization (e.g.,
Fonagy et al. 1995), a n d self-organization (e.g., Fischer a n d
Ayoub 1994)—were retained.
In t h e last q u a r t e r of t h e twentieth century, developmental
psychopathologists were mostly concerned with risk factors—
risk factors associated with t h e family occupying a m o s t impor-
t a n t role (e.g., M a s t e n a n d Garmezy 1985). Developmental psy-
chopathology of t h e early y e a r s of development w a s particularly
concerned with social a n d c u l t u r a l facets of risk (e.g., M a s t e n
a n d Braswell 1991), p a r e n t - i n f a n t relationships, epistemic a n d
motivational m e n t a l s t a t e s t h a t influence p a r e n t i n g (e.g., Belsky
1984), t h e interaction of economic a n d social d i s a d v a n t a g e with
p a r e n t i n g (e.g., McLoyd 1990; Quinton, Rutter, a n d Liddle 1984),
t h e distorting influences of p a s t experience on emotional a n d
cognitive s t r u c t u r e s of t h e child (e.g., Fox, Platz, a n d Bentley
1995; Parker, Barrett, a n d Hickie 1992), a n d p a r e n t a l behaviors
a s m e d i a t o r s of t h e gross social inequalities t h a t b e c a m e a n
increasing s o u r c e of concern for social scientists of t h e T h a t c h e r
a n d Reagan y e a r s (e.g., Conger, Ge, Elder, Lorenz, a n d S i m o n s
1994; McLoyd 1998; Petit, Bates, a n d Dodge 1997). Permeating
 A Psychosocial Model of the Development of Mentalization / 103

all t h e s e i d e a s w a s t h e notion t h a t t h e unfolding of psycho

pathology occurred in t h e context o f t h e child's p r i m a r y socializa-
tion environment: t h e family. T h e family, t h e p a r e n t s in parti-
cular, provided t h e b a c k d r o p a g a i n s t w h i c h t h i s unfolding oc-
curred—rtheir characteristics were crucial to t h e developmental
choices t h e child would m a k e , their actions a n d collaboration
critical to b o t h t r e a t m e n t a n d prevention.
However, over t h e last d e c a d e of t h e twentieth century, per-
h a p s in p a r t triggered by t h e excitement of t h e h u m a n genome
project, b u t also by r e s e a r c h designs of increasing statistical
sophistication, quantitative behavior genetics w a s u n l e a s h e d on
early development r e s e a r c h . At a certain point it seemed a s
t h o u g h r e s e a r c h in genetics h a d all b u t eliminated t h e place
for classical socialization theories t h a t placed a n e m p h a s i s on
parenting, s u c h a s a t t a c h m e n t theory, a n d h a d refuted all theo-
ries t h a t advocated t h e key role of early family experience (see
Scarr 1992). For example, t h e behavior geneticist Rowe wrote:
"parents in m o s t working to professional class families m a y
have little influence on w h a t traits their children m a y eventually
develop a s adults" (1994, p. 7). He w e n t on to say t h a t h e
doubted w h e t h e r a n y u n d e s i r a b l e trait displayed by a child c a n
be significantly modified by a n y t h i n g a . p a r e n t does. In fairness,
it should b e noted t h a t t h e s e c o m m e n t s were p u b l i s h e d before
data b e c a m e available from r e s e a r c h t h a t gave equal weight to
both genetic a n d social influences on development.

The Findings from Behavior G e n e t i c s

The biological (genetic) m o v e m e n t of t h e 1990s highlighted a

n u m b e r of i s s u e s t h a t s e e m e d to t h r e a t e n t h e validity of t h e
kinds of environmentalist claims we a r e m a k i n g in this book.

1. The overall connection between early p a r e n t i n g a n d social-

ization o u t c o m e s t u r n s o u t to b e quite weak, a n d in longitudinal
studies p a r e n t i n g a c c o u n t s for negligible proportions of t h e vari-
ance. There is very limited evidence t h a t m i g h t link early
relationship experiences to t h e development of personality a n d
psychopathology. F u r t h e r m o r e , t h e implicit a s s u m p t i o n t h a t
 104 / Theoretical Perspectives

genetic influences occur only in early life, a n d therefore t h a t

later emerging differences between individuals c a n be safely
a s s u m e d to be environmental, t u r n s o u t to be false. Genetic
influences a r e j u s t a s c h a n g i n g a n d a s d y n a m i c a s environmen-
tal influences. For example, genetic influences on IQ a r e rela-
tively small in early y e a r s b u t increase considerably a s t h e child
moves toward adolescence (Rutter et al. 1997) a n d conversely
t h e influence of p a r e n t i n g on a p t i t u d e t e s t scores declines
(Plomin, Fulker, Corley, a n d DeFries 1997). As we shall see, it is
quite possible t h a t a t t h e molecular level s o m e genes a r e dor-
m a n t in early p h a s e s of development b u t their activity is pro-
moted in s u b s e q u e n t stages. In fact, genetic influences pre-
disposing to t h e s a m e t r a i t — s u c h a s antisocial behavior—can
c h a n g e over t h e c o u r s e of development w i t h o u t altering t h e size
of t h e genetic c o m p o n e n t . T h u s , t h e heritability of antisocial
behavior is 63% in early adolescence a n d 6 8 % in late adoles-
cence, b u t only a b o u t a third of this variability overlaps (i.e., is
t h e s a m e p a r t of t h e genetic m a k e u p a t e a c h stage) (Neiderhiser,
Reiss, a n d Hetheringtoh 1996).

2. Behavior-genetic models of twin a n d adoption s t u d i e s par-

tition variability into genetic (h) a n d environmental (E) compo-
n e n t s by s u b t r a c t i n g t h e proportion of variability on a specific
trait a c c o u n t e d for by genes (h2) from 100 (E = 100 - h 2 ). In m o s t
d o m a i n s h 2 is 5 0 - 6 0 % , with less t h a n half left to E. For atten-
tion-deficit hyperactivity disorder (ADHD), heritability is esti-
m a t e d to vary from 55% to 8 2 % (Nigg a n d Goldsmith 1998;
Smalley 1997) As large-scale s t u d i e s c o n t i n u e to emerge, t h e
proportion of variance t h a t is left after s u b t r a c t i n g genetic influ-
ence is diminishing.

3. Behavior-genetics r e s e a r c h h a s revealed t h a t influences t h a t

h a d previously b e e n considered environmental (such a s children
whose caregivers read to t h e m learning to read earlier t h a n those
who are n o t read to) were actually mostly mediated by t h e
s h a r e d genetic predisposition of caregiver a n d offspring (Kendler
et al. 1996). Apparently environmentally mediated family influ-
ences are in fact explained by t h e s h a r e d genetic predisposition
of caregiver a n d offspring a n d therefore are possibly in t h e m -
 A Psychosocial Model ofthe Development of Mentalization / 105

selves u n i m p o r t a n t (J. R. Harris 1998; Rowe 1994). Recently, a n

analysis of t h e Colorado Adoption Project showed t h a t m a n y of
the milder adverse effects o n social, a d j u s t m e n t associated with
p a r e n t a l divorce a r e in fact genetic: children w h o a r e a d o p t e d
away from p a r e n t s w h o later get divorced develop a d j u s t m e n t
problems even if t h e y are a d o p t e d into nondivorcing families
(O'Connor, Caspi, DeFries, arid Plomin 2000). The quality o f t h e
e n v i r o n m e n t s t h a t a r e t h o u g h t to b e so i m p o r t a n t to develop-
ment, including s t r e s s , life events, a n d t r a u m a (and probably
also m a t e r n a l a t t u n e m e n t a n d sensitivity), c a n all be inherited.
It is likely t h a t personality characteristics t h a t we h a d often
t h o u g h t of a s — a n d w h a t t h e child m i g h t experience as—the
c o n s e q u e n c e of t h e p a r e n t s ' behavior toward t h e child are in fact
genetic predispositions. It might be t h a t t h e p a r t i c u l a r personal-
ity trait in t h e child a n d t h e associated form of p a r e n t i n g (criti-
cism, w a r m t h , or even abuse) are b o t h c o n s e q u e n c e s o f t h e s a m e
genes in t h e p a r e n t a n d t h e child or t h a t t h e prodromal version
o f t h e child's trait might elicit—say, by evocatory projective iden-
tification (Spillius 1992)—a p a r t i c u l a r way for t h e p a r e n t to be
with t h e child.

4. Correlations between characteristics of early p a r e n t i n g a n d

later child behavior c a n be reinterpreted given t h a t a n y associa-
tion m a y be a t t r i b u t a b l e to t h e 50% of genetic overlap between a
p a r e n t a n d a biological child. This h a s b e e n termed passive
genotype-environment correlation. As genetic factors influence
the i n d e p e n d e n t variables ( m e a s u r e s of t h e social environment)
and t h e d e p e n d e n t variables ( m e a s u r e s of social adjustment),
there is a potential for confounding. In t h e majority of published
socialization s t u d i e s t h i s possibility is n o t acknowledged. Reiss,
Neiderhiser, Hetherington, a n d Plomin (2000), in a l a n d m a r k
investigation of genetic a n d environmental influences on adoles-
cent development, found t h a t of 52 statistically significant asso-
ciations between family relationship (e.g., p a r e n t a l w a r m t h or
sibling relationships) a n d m e a s u r e s of a d j u s t m e n t (e.g., depres-
sion a n d antisocial behavior), 4 4 showed genetic influences t h a t
accounted for m o r e t h a n half of t h e covariance. In a l m o s t half of
the 52, little association between family relations a n d adolescent
functioning r e m a i n e d once genetic influence w a s t a k e n into con-
 106 / Theoretical Perspectives

sideration. In t h e Colorado Adoption Project, t h e parents* report

of w a r m t h v e r s u s negativity in t h e family a n d t h e child's report
of achievement orientation a p p e a r associated, b u t achievement
orientation t u r n s o u t to be genetically d e t e n n i n e d , suggesting
t h a t a s p e c t s of t h e family e n v i r o n m e n t a r e susceptible to the
influence of t h e child's genetically rooted c h a r a c t e r i s t i c s ^ - t h e
so-called child-to-parent effects (Deater-Deckard, Fulker, a n d
Plomin 1999).

5. Insofar a s behavior-genetic s t u d i e s showed family environ-

m e n t to m a t t e r , it w a s t h e e n v i r o n m e n t specific to e a c h child
within t h e s a m e family [nonshared environment) t h a t m a t t e r e d
(Plomin a n d Daniels 1987). E n v i r o n m e n t m a y b e partitioned into
a s h a r e d a n d a n o n s h a r e d c o m p o n e n t . S h a r e d environmental
influences m a y b e e s t i m a t e d in adoption s t u d i e s b y comparing
t h e correlation of adopted children a n d their adopted siblings
with children in other h o u s e h o l d s . If s h a r e d a s p e c t s of the
environment, s u c h a s parenting, were indeed formative, t h e n
adopted siblings living in t h e s a m e h o m e s h o u l d be significantly
more alike t h a n u n r e l a t e d children a c r o s s h o u s e h o l d s . After t h e
genetic a n d s h a r e d environmental c o m p o n e n t s a r e estimated,
w h a t r e m a i n s is t h e n o n s h a r e d e n v i r o n m e n t (E us = 100 - h 2 - E J .
T h e n o n s h a r e d e n v i r o n m e n t a p p e a r s to be t h e b u l k of t h e en-
vironmental component; s h a r e d environment, a n i n s t a n c e of
w h i c h would b e p a r e n t a l sensitivity, a c c o u n t s for a l m o s t n o
variance (Plomin 1994). Adopted children, it seems, are n o more
like their adopted siblings t h a n are u n r e l a t e d children growing
u p in a different h o u s e h o l d (Plomin a n d B e r g e m a n 1991). This is
i m p o r t a n t b e c a u s e t h e relatively weak observed effects of t h e
s h a r e d environment have b e e n u s e d to suggest t h a t environ-
m e n t s generally a s s u m e d to be toxic by developmental psycho-
pathology (such a s high level of p a r e n t a l conflict, p a r e n t a l psy-
chiatric d i s t u r b a n c e , or even relative social disadvantage) are
either of less i m p o r t a n c e t h a n previously t h o u g h t or, m o r e prob-
ably, are actually genetically mediated (Plomin, Chipuer, a n d
Neiderhiser 1994). Plomin p u t this quite elegantly:

So often we have assumed that the key influences on children's

development are shared: their parents' personality and child-
 A Psychosocial Model of the Development of Mentalization / 107

hood experiences, the quality of their parents' marriage relation-

ship, children's educational background, the neighborhood in
which they grow up, and their parents' attitude to school or to
discipline. Yet to the extent that these Influences are shared,
they cannot account for the differences we observe in children's
outcomes. [1994, p. 23]

6. It h a s b e e n a r g u e d t h a t even n o n s h a r e d environmental
effects m a y b e b e t t e r u n d e r s t o o d a s being genetic in origin.
Genetically influenced a s p e c t s of children's behavior m a y be
responsible for provoking specific observed r e s p o n s e s in p a r e n t s
and other people. This is s o m e t i m e s termed evocative covariance,
when children with different genetic predispositions elicit com-
plementary r e s p o n s e s from t h e caregiver. T h u s , t h e child's
n o n s h a r e d (specific) e n v i r o n m e n t m a y s o m e t i m e s have b e e n
erroneously a t t r i b u t e d to p a r e n t a l behavior r a t h e r t h a n to h i s
genes (O'Connor, Deater-Deckard, Fulker, Rutter, a n d Plomin
1998). S o m e s t u d i e s of adopted children suggest t h a t authori-
tarian parenting, w h i c h h a s b e e n t h o u g h t to a c c o u n t for op-
positional behavior in children, m a y b e elicited by t h e child's
resistive or distractible behavior (Ge, Conger, Cadoret, Neider-
hiser, a n d Yates 1996).

Thus, it s e e m s t h a t over t h e p a s t ten y e a r s we—developmental

professionals a s well a s t h e lay public—have unconsciously
switched from a primarily psychosocial model of child a n d a d u l t
development consistent with p s y c h o d y n a m i c ideas to a genetic-
biological frame of reference t h a t often a priori excludes consid-
eration of c h i l d - p a r e n t relationships. We will now a r g u e t h a t t h e
case for r e d u c i n g t h e e m p h a s i s on parenting, particularly t h e
e m p h a s i s on t h e early a t t a c h m e n t relationships, is b a s e d on
false evaluations of behavior-genetic d a t a , a n d t h a t p e r h a p s in
the p a s t o u r e m p h a s i s on t h e role of p a r e n t i n g w a s s o m e w h a t
naive in trying to see t h e p a r e n t s ' influence simply in t e r m s of
relationship quality, internalization, introjection, identification,
and so on. We try to s h o w t h a t (a) early a t t a c h m e n t experiences
may well be key m o d e r a t o r s of t h e expression of individual
genotype, a n d (b) t h e p r i m a r y evolutionary function of a t t a c h -
m e n t m a y indeed b e t h e contribution it m a k e s to t h e ontogenetic
108 / Theoretical Perspectives

creation of a m e n t a l m e c h a n i s m t h a t could serve to m o d e r a t e

psychosocial experiences relevant for gene expression.

S c r u t i n i z i n g t h e C a s e for G e n e t i c s

As d e m o n s t r a t e d earlier, t h e case for genetic d e t e r m i n a n t s r e s t s

on two pillars: (a) t h e w e a k n e s s o f t h e socialization evidence, a n d
(b) t h e findings of quantitative behavior genetics. We will j u s t
t o u c h on t h e first a n d focus ori t h e second.
Classical reviews extensively cited by behavior geneticists
(e.g., Maccoby a n d Martin 1983) t e n d e d to reveal w e a k correla-
tions between p a r e n t i n g and- socialization o u t c o m e s open to
alternative, genetic interpretations. However, t h e r e h a v e been
s u b s t a n t i a l methodological i m p r o v e m e n t s in s t u d i e s of social-
ization, in t e r m s b o t h of t h e b r e a d t h a n d of t h e d e p t h of meas-
u r e m e n t , a n d correspondingly effect sizes h a v e also increased.
For example, Martin M a l d o n a d o - D u r a n a n d h i s colleagues, in a
s t u d y a t t h e Menninger Child a n d Family Center (Maldonado-
D u r a n , Helmig, Moody, a n d Millhuff, in press; M a l d o n a d o - D u r a n
et al. in press), carried o u t operationalized clinical ratings of
a l m o s t 150 infants. Over 70% of t h e children have so far been
followed u p two to four y e a r s later. Infant behavior problems
strongly predicted later behavioral difficulties in a n u m b e r of
a r e a s . Parenting observed in infancy predicted preschool emo-
tional difficulties. In particular, p a r e n t s w h o were b o t h neglect-
ful a n d hostile h a d children with m o r e behavioral problems. This
r e m a i n e d t r u e even w h e n behavioral p r o b l e m s in infancy were
controlled for. Observed neglect a n d hostility toward t h e child
correlated 0 . 3 6 with t h e child's behavioral p r o b l e m s noted a t age
4 years, even w h e n infant behavior w a s already controlled for.
This implies t h a t p a r e n t i n g h a d a predictable effect beyond t h a t
which could be explained in t e r m s of t h e p a r e n t r e s p o n d i n g
specifically to t h e p r e c u r s o r s of t h e child's behavioral problems.
Better-controlled studies, s u c h a s t h i s one, a r e a c c u m u l a t i n g ,
a n d c u r r e n t reviews of t h e socialization literature tend to yield
more encouraging conclusions (Maccoby 2000).
A considerable complexity is introduced into t h e interpreta-
tion of social e n v i r o n m e n t to behavioral-outcome correlations by
 A Psychosocial Model of the Development of Mentalization / 109

the recognition t h a t t h e p a r e n t i n g environment varies in signifi-

cance a c r o s s development a n d even within e a c h developmental
p h a s e a c r o s s time. T h e r a p e u t i c experience shows u s t h e excep-
tional influence of certain "key m o m e n t s " of interaction between
therapist a n d patient, w h e n experience b r o u g h t into clear relief
by a confluence of c i r c u m s t a n c e a n d intrapsychic factors s u d -
denly e n a b l e s t h e r a p e u t i c change. (This idea is fully elaborated
in the work of Daniel Stern, Ed Tronick, Karlen Lyons-Ruth, a n d
the Boston g r o u p o n t h e r a p e u t i c process—Fonagy 1998; Lyons-
Ruth 1999; S t e r n 1998; S t e r n et al. 1998.) They a r g u e t h a t
change in t h e r a p y might be a function of special m o m e n t s of
a t t u n e m e n t between t h e r a p i s t a n d patient. More generally, t h e
s a m e could apply to special m o m e n t s of influence of p a r e n t s on
children—naturally with b o t h a positive a n d a negative valence—
m o m e n t s of p a r e n t i n g influence, however key a n d formative,
t h a t m i g h t be t h e needles in a socialization h a y s t a c k . It is
difficult to imagine h o w observational research, focusing on
aggregate or t i m e r s a m p l e d behaviors, c a n h o p e to c a p t u r e sig-
nificant n u m b e r s of s u c h key m o m e n t s . The correlations be-
tween observed p a r e n t i n g a n d child o u t c o m e m a y never reflect
the t r u e influence of p a r e n t i n g .
In a n y case, however s t r o n g t h e associations between p a -
renting a n d socialization, t h e possibility t h a t t h e m o r e parsimo-
nious explanation is genetic c a n n o t b e ruled out. It is t h e a p -
parent s t r e n g t h of genetic findings, t h e massive proportion of
variability a c c o u n t e d for, n o m a t t e r how specific t h e trait, t h a t
casts s u c h a d a r k s h a d o w over developmental psychopathology.
But a r e t h e genetic findings a s unequivocal a s they s e e m ? Let u s
offer a brief, r o b u s t r e b u t t a l of quantitative behavior genetics.
The evidence from behavior genetics should be interpreted
with caution. T h e r e a s o n s are: (a) methodological, (b) conceptual,
and (c) empirical. Methodologically, t h e c o n t r a s t of identical a n d
fraternal twins confounds genetic similarity a n d environmental
influence. It h a s b e e n claimed t h a t identical twins h a v e more
similar e n v i r o n m e n t s t h a n do fraternal o n e s (e.g., they have
more friends in c o m m o n , t h e y a r e treated m o r e similarly by t h e
p a r e n t s ^ R e i s s et al. 2000). T h e s t a t u s of inferring environmen-
tal effects by a p r o c e s s of s u b t r a c t i o n u s i n g t h e additive model
h a s also b e e n questioned (Elman et al. 1996; T u r k h e i m e r 1998).
110 / Theoretical Perspectives

In particular, • E is e s t i m a t e d w i t h o u t a n y direct m e a s u r e of
environmental factors. If t h e estimate for heritability, G, is high,
E m u s t be low. In reality, G a n d E combine to g e n e r a t e a
phenotype. In simple additive models, however, this interaction
would be pooled with genetic effects. T h e u s e of p a r e n t s a s a
source of d a t a a b o u t themselves a s well a s their child c r e a t e s a n
inbuilt genetic bias. Heritability e s t i m a t e s a r e inflated by t h e u s e
of p a r e n t s ' r e p o r t s of child behavior r a t h e r t h a n behavioral ob-
servation or self-reports. It is n o t s u r p r i s i n g t h a t w h e n p a r e n t s
rate a child's aggression, t h e correlation with' t h e p a r e n t ' s ag-
gression should i n c r e a s e (Cadoret, Leve, a n d Devor 1997; Miles
a n d Carey 1997).
At a c o n c e p t u a l level, we m a y certainly q u e s t i o n t h e notion of
n o n s h a r e d environment, since it merely refers to intersibling
differences, n o t to their environment. In fact, s h a r e d environ-
m e n t s could a s easily serve to m a k e children in t h e family
different from o n e a n o t h e r a s to i n c r e a s e intrafamilial similarity,
since s h a r e d e n v i r o n m e n t s m a y b e experienced very differently
by two children. A further c o n c e p t u a l problem c o n c e r n s herit-
ability e s t i m a t e s b a s e d solely on individual differences—esti-
m a t e s t h a t remove s h a r e d environmental effects s u c h a s secular
t r e n d s a n d are strictly restricted to t h e e n v i r o n m e n t studied.
Height, IQ, a s well a s t h e prevalence of a n u m b e r of psychologi-
cal disorders (such a s delinquency a n d eating disorder) have
increased markedly over t h e last century, u n d o u b t e d l y a s a
c o n s e q u e n c e of environmental c h a n g e s , yet c u r r e n t behavioral-
genetic m e t h o d s of estimating e n v i r o n m e n t a l effects preclude
consideration of t h e s e .
Empirically, we could point to s t u d i e s w h e r e environmental
d e t e r m i n a n t s revealed s u b s t a n t i a l effects after genetic influences
h a d b e e n excluded (Johnson, Cohen, Brown, Smailes, a n d Bern-
stein 1999). We could raise q u e s t i o n s a b o u t t h e a c t u a l — r a t h e r
t h a n assumed—differential r e s p o n s i v e n e s s of caregivers to sib-
lings. Evidence on j u s t how differently siblings a r e treated is
actually quite mixed. In one o f t h e only behavioral-genetic s t u d -
ies to actually look a t t h e child's e n v i r o n m e n t r a t h e r t h a n simply
infer it, Reiss, Plomin, Hetherington, a n d colleagues found direct
evidence for t h e notion of t h e n o n s h a r e d e n v i r o n m e n t (Reiss et
 A Psychosocial Model ofthe Development of Mentalization / 111

al. 2000). T h e difference between t h e degree of coerciveness of

parenting between a pair of twins w a s m o r e predictive t h a n w a s
the a b s o l u t e level of negativity (Reiss et al. 1995). However, J u d y
D u n n ' s n a t u r a l i s t i c observational s t u d i e s of siblings actually
suggest t h a t while cross-sectionally p a r e n t s m a y a p p e a r to be
treating siblings differently, looked a t longitudinally children a t
various ages receive c o m p a r a b l e t r e a t m e n t (Dunn a n d McGuire
1994). T h e obvious implication h e r e is for a more systemic
approach.
Regardless of t h e u l t i m a t e conclusion concerning t h e differing
t r e a t m e n t of siblings, t h e fact t h a t s t u d i e s of social development
have t e n d e d to look a t single children implied t h a t they have on
the whole u n d e r e s t i m a t e d t h e i m p a c t of p a r e n t i n g a n d other
shared environmental influences. As we shall see later on, t h e r e
may be specific p r e s s u r e s in family s y s t e m s for different re-
sponses of siblings a s p a r t o f t h e n e e d for e a c h p e r s o n within t h e
system to h a v e a u n i q u e role. Interestingly, t h e p r e s s u r e for
difference m a y b e greater w h e n genetic differentiation is least. In
a recent study, P a s c o F e a r o n a n d Peter Fonagy a t t e m p t e d to
establish t h e role of genetic influence on p a t t e r n s of a t t a c h m e n t
(Fonagy, Fearon, a n d Target 1999). The question concerning
genetic influence w a s raised by t r a n s g e n e r a t i o n a l s t u d i e s of
consistency in a t t a c h m e n t p a t t e r n s (mothers w h o s e a t t a c h m e n t
was s e c u r e before t h e birth of t h e child t e n d e d to h a v e b a b i e s
securely a t t a c h e d to t h e m o n e y e a r later—van IJzendoorn 1995).
Is this a n o t h e r example of a genetic effect? In a s t u d y of identical
and nonidentical twins, we found very little evidence for greater
concordance of a t t a c h m e n t p a t t e r n s a m o n g monozygotic twins.
However, we found t h a t t h e likelihood of concordance in a t t a c h -
ment p a t t e r n s w a s predicted by m o t h e r s ' a s s e s s m e n t of t h e
t e m p e r a m e n t s of their twins. Briefly, t h e m o r e similar t h e
mother r a t e d t h e two infants' t e m p e r a m e n t s , t h e more likely it
was t h a t t h e twins' a t t a c h m e n t classifications were to be dis-
similar. Conversely, t h e m o r e t h e m o t h e r differentiated between
the t e m p e r a m e n t s of h e r twins, t h e m o r e likely t h e y would be
congruent in t e r m s of their a t t a c h m e n t classification. In inter^
preting t h e s e r e s u l t s , we tentatively suggest t h a t if t h e m o t h e r
fails to differentiate between h e r children consciously, s h e is
112 / Theoretical Perspectives

m o r e likely to project u n c o n s c i o u s expectations o n t o o n e or

other twin, forcing t h e m to be different in relation to her. Alter-
natively, being s e e n a s different a t some level m a y m e a n t h a t the
twins do n o t feel t h a t they h a v e to find a place for themselves in
t h e family system. If t h e m o t h e r is able to see their individuality,
t h e n they c a n b e h a v e consistently with their predispositions.
F u r t h e r m o r e , on occasion experimental m a n i p u l a t i o n s of the
environment a s p a r t of t r e a t m e n t a n d prevention interventions
have yielded relatively large effects. It is noteworthy t h a t neither
of t h e two major a t t a c k s on t h e i m p o r t a n c e of family on social-
ization (J. R. Harris 1998; Rowe 1994) covers p a r e n t training.
The average effect size of p a r e n t training for children with Oppo-
sitional Defiant Disorder is a r o u n d 1 (Serketich a n d D u m a s
1996), which m e a n s t h a t t h e average treated child is b e t t e r off at
t h e e n d of t r e a t m e n t t h a n a t least 8 4 % of t h e controls. More
relevant in t h i s context is t h e fact t h a t a c c u m u l a t i n g evidence
s u p p o r t s t h e usefulness of experimental interventions with par-
ents, s u c h a s h o m e visitation (e.g., Olds et al. 1998), with long-
t e r m beneficial effects in r e d u c i n g t h e risk of criminality a n d
delinquency. Of course, t h e impact of e n v i r o n m e n t a l m a n i p u l a -
tion is often not a s large a s one would hope; moreover, long-term
follow-ups in t r e a t m e n t s t u d i e s a r e relatively rare, a n d even
quite impressive c h a n g e s initiated by experimental interventions
dissipate (Fonagy, Target, Cottrell, Phillips, a n d Kurtz 2000).
As clinicians, o u r m a i n objection to behavior-genetic d a t a
would n o t be methodological, conceptual, or empirical but,
r a t h e r , pragmatic. Genetic effects m a y well b e indirect a s well a s
direct. Even a high genetic loading for a certain environmental
h a z a r d does n o t m e a n t h a t t h e c o n s e q u e n c e s associated with
t h a t risk factor would necessarily be genetically r a t h e r t h a n
environmentally mediated. For example, if child a b u s e were
found to have a large genetic component, its toxic effects would
still be via t h e d e s t r u c t i o n of t r u s t in t h e world for t h e a b u s e d
child r a t h e r t h a n via a purely genetic process. T h e implications
of behavior-genetic d a t a for clinical intervention a r e t h u s quite
limited. B u t t h e continuing t e n s i o n between perspectives based
on genetics r e s e a r c h a n d environmental s t u d i e s s h o u l d n o t be
played o u t on t h e battlefield of t h e a s s u m p t i o n s underlying the
genetic model. The findings from behavior genetics a p p e a r quite
 A Psychosocial Model of the Development of Mentalization / 113

robust, a n d t h e b u r d e n is o n environmentalists to integrate t h e

genetic d a t a with their theories. W h a t follows is a very m o d e s t
preliminary a t t e m p t a t t h e integration of selective genetics find-
ings with environmentalist observations arising from t h e field
u n d e r consideration in t h i s volume: t h e relationship of m e n t a l -
ization a n d early a t t a c h m e n t relationships.

SUBJECTIVITY AT T H E INTERFACE
OF GENE AND ENVIRONMENT

The Role of E x p e r i e n c e
in t h e E x p r e s s i o n o f t h e G e n o t y p e

It is universally acknowledged t h a t developmental psychopathol-

ogy involves a g e n e - e n v i r o n m e n t interaction. In t h e case of
honeybees, t h e reproductive a n d social roles of colony m e m b e r s
are fixed by e v e n t s t h a t o c c u r d u r i n g t h e first few days of larval
development. Worker or q u e e n bee s t a t u s is a p p a r e n t l y n o t
encoded in t h e genotype b u t follows from t h e differential treat-
m e n t of larvae by w o r k e r bees, resulting in differential gene
expression—both up-regulation a n d down-regulation (Evans a n d
Wheeler 2000). S o m e quantitative h u m a n behavior-genetic s t u d -
ies also strongly suggest interactive p r o c e s s e s whereby environ-
mental e x p o s u r e triggers genetic vulnerability. For example, t h e
classic F i n n i s h adoptive-family s t u d y of schizophrenia s u g g e s t s
t h a t children with a schizophrenic biological p a r e n t were m o r e
likely to develop a r a n g e of psychiatric p r o b l e m s if, a n d only if,
they were a d o p t e d into dysfunctional families (Tienari, Wynne,
Moring, Lahti, a n d N a a r a l a 1994). B o h m a n (1996) reported t h a t
criminality a p p e a r e d to b e associated with a genetic risk only if
children w h o s e biological p a r e n t s were criminals were adopted
into dysfunctional h o m e s . So genetic risk m a y or m a y n o t be-
come manifest, d e p e n d i n g on t h e quality of t h e family environ-
m e n t to which a child is exposed. B u t if t h i s is s u c h a pervasive
process, t h e n w h y is t h e quantitative behavior-genetic evidence
for g e n e - e n v i r o n m e n t interaction so s p a r s e ? Empirically, t h i s
114 / Theoretical Perspectives

interaction t e r m h a s proved to be quite h a r d to find. Plomin's

(Plomin, DeFries, McLearn, a n d Rutter 1997) s y s t e m a t i c review
of t h e literature, now admittedly s o m e w h a t dated, found evi-
dence only for relatively isolated examples.
We suggest t h a t t h e a n s w e r lies in t h e fact t h a t behavior
genetics sometimes s t u d i e s t h e "wrong" environment, b e c a u s e
the environment t h a t triggers t h e expression of a gene is n o t
objective. Gene expression is n o t triggered by t h e observable,
objective environment. The child's experience ofthe environment
is w h a t c o u n t s . T h e m a n n e r in w h i c h e n v i r o n m e n t is experi-
enced will a c t a s a filter in t h e expression of genotype into
phenotype. And h e r e we t o u c h on t h e pivotal i m p o r t a n c e of
psychoanalysis a n d a t t a c h m e n t theory, t h e p r i m a r y concern of
which is with t h e interaction of multiple layers of representa-
tions in generating developmental o u t c o m e s . D a t a from genetics
call for exactly s u c h sophistication in u n d e r s t a n d i n g t h e way
genes m a y or m a y n o t be expressed in p a r t i c u l a r individuals.
T h e p a t h w a y between genes a n d p h e n o t y p e s is a t o r t u o u s
one, with genetics a n d e n v i r o n m e n t constantly interacting
(Elman et al. 1996). At t h e molecular level, evidence suggests
t h a t positive a n d negative e n v i r o n m e n t s m a y alter gene expres-
sion—that is, t h e rate a t w h i c h genes are t r a n s c r i b e d into RNA
a n d s u b s e q u e n t protein s y n t h e s i s t h a t can, a t least in principle,
influence t h e s t r u c t u r e a n d functioning of t h e h u m a n brain.
Internal a n d external stimuli, s t e p s in t h e development of the
brain, h o r m o n e s , stress, learning, a n d social interaction all alter
the binding of t r a n s c r i p t i o n regulators (Kandel 1998). Of particu-
lar interest are a n i m a l s t u d i e s t h a t suggest t h a t various forms of
learning in a n i m a l s reflect a p r o c e s s w h e r e b y environmental
stimuli—such a s songs a n d calls from, one bird to a n o t h e r — m a y
activate t h e t r a n s c r i p t i o n of RNA from d o r m a n t genes, leading to
new proteins being synthesized a n d c h a n g e s of synaptic struc-
t u r e a n d function (Chew, Vicario, a n d Nottebohm 1996; Nguyen,
Abel, a n d Kandel 1994). The very p r o c e s s of learning m a y be
genetically controlled. Environmental stimuli involved in the
conditioning of gill reflexes in Aplysia a c t to t u r n off memory
s u p p r e s s o r genes (Abel a n d Kandel 1998). P e r h a p s m o r e relevant
to u s from a n a t t a c h m e n t s t a n d p o i n t a r e t h e classic s t u d i e s of
r a t p u p s s e p a r a t e d from their m o t h e r in t h e first two weeks of
 A Psychosocial Model ofthe Development of Mentalization / 115

life, who a p p e a r to i n c u r a p e r m a n e n t increase in t h e expression

of genes controlling t h e secretion of CRF (corticotrophm-releas-
ing factor) (Plotsky a n d Meaney 1993). While t h e m a t e r n a l l y
deprived r a t p u p s m a y acquire a life-long vulnerability to s t r e s s
t h r o u g h t h i s p e r m a n e n t i n c r e a s e in gene expression, d a m s w h o
showed increased care of their p u p s by licking a n d grooming
t h e m d u r i n g n u r s i n g seemed to provide t h e m with a life-long
protection from s t r e s s . This latter p r o c e s s a p p e a r e d to be medi-
ated t h r o u g h t h e e n h a n c e d expression of genes regulating gluco-
corticoid receptors a n d t h e c o n s e q u e n t s u p p r e s s i o n of genes
regulating CRF s y n t h e s i s (Liu et al. 1997).
There is s u b s t a n t i a l individual variability in r e s p o n s e to
stress a n d adversity. M u c h of t h i s variability is poorly u n d e r -
stood (Rutter 1999), b u t it u n d e r s c o r e s t h e potential i m p o r t a n c e
of intrapsychic variables. W h e t h e r or n o t specific environmental
factors trigger t h e expression of a gene m a y depend n o t only on
the n a t u r e of t h o s e factors, b u t also on t h e way t h e infant or
child experiences t h e m , w h i c h will be a n intrapsychic function
t h a t is d e t e r m i n e d by c o n s c i o u s or u n c o n s c i o u s m e a n i n g attri-
bution to t h e s e experiences. T h e quality of t h e experiential filter
t h a t a t t a c h m e n t provides may, in t u r n , be a function of either
genetic or environmental influences, or their interaction (Kandel
1998). T h u s i n t r a p s y c h i c r e p r e s e n t a t i o n a l p r o c e s s e s are n o t j u s t
the c o n s e q u e n c e s of environmental a n d genetic effects—they
may be critical m o d e r a t o r s of t h e s e effects.
This h a s s u b s t a n t i a l clinical significance, since t h e u n d e r -
standing of a n e n v i r o n m e n t by t h e child is m o r e readily modifi-
able t h a n are t h e e n v i r o n m e n t itself or t h e genes with which t h e
environment i n t e r a c t s (Emde 1988). An a t t a c h m e n t - t h e o r y in-
trapsychic perspective m a y be helpful in considering n o t j u s t
what precipitates personality a n d its disorders, b u t also w h i c h
processes influence t h e c o u r s e of t h e disorder for better or
worse. Until t h e l a s t five y e a r s this w a s theory, b u t now t h e
collaboration of molecular geneticists a n d a t t a c h m e n t theory is
making it a reality. We will offer t h r e e examples of t h i s powerful
paradigm.
There is excellent evidence from R h e s u s m o n k e y s (Suomi
2000) t h a t individuals w h o carry t h e "short" allele of t h e 5-HTT
gene a r e significantly m o r e severely affected by m a t e r n a l depri-
116 / Theoretical Perspectives

vation t h a n are individuals with t h e "long" allele (Bennett et al.,

2002). Actually t h e full story is s o m e w h a t m o r e complicated. The
work of Suomi's laboratory over t h e l a s t d e c a d e d e m o n s t r a t e d
t h a t peer-reared (maternally deprived) infants grow u p to be
socially a n x i o u s in n a t u r e , to h a v e a reactive t e m p e r a m e n t (a
tendency to become emotionally a r o u s e d , aggressive, impulsive,
a n d fearful), a n d to drop to t h e b o t t o m of d o m i n a n c e hierarchies
(Higley, King, e t al. 1996; S u o m i 1997). If their early a t t a c h m e n t
experiences a r e poor, t h e n their n e u r o - e n d o c r i n e functioning
will become highly a b n o r m a l ; they will h a v e lower CSF (cerebro-
spinal fluid) c o n c e n t r a t i o n s of 5-HIAA (Higley, Supmi, a n d
Linnoila 1996), indicating d e c r e a s e d serotonergic functioning.
They will also c o n s u m e larger a m o u n t s of alcohol (Higley,
Hasert, Suomi, a n d Linnoila 1991) a n d will develop tolerance to
it faster, in line with their serotonin t u r n o v e r r a t e s (Higley et al.
in press), which, in t u r n , is associated with serotonin t r a n s -
porter availability (Heinz et al. 1998). The 5-HTT is t h e serotonin
t r a n s p o r t e r gene t h a t h a s b e e n implicated' in impaired serot-
onergic function (Lesch et al. 1996) for t h e s h o r t allele of the
gene (Heils et al. 1996). ! In t h e S u o m i r h e s u s - m o n k e y colony,
5-HIAA CSF concentration w a s lower in m o n k e y s with t h e s h o r t
allele of 5-HTT—^-but only for peer-reared monkeys. For mother-
reared subjects, 5-HIAA c o n c e n t r a t i o n s were identical for m o n -
keys with either allele (Bennett et al. 2002). T h e experience of a n
i n a d e q u a t e early environment triggered t h e expression of t h e 5-
HTT gene.
T h e reversibility of genetic vulnerability w a s indicated in
s t u d i e s where t h e foster-mothering of specially b r e d high-reac-
tive m o n k e y infants w a s experimentally m a n i p u l a t e d . Reactive
infants assigned to n u r t u r a n t foster-mothers a p p e a r e d to be

'The literature reveals four studies that found an association between the
short allele and harm avoidance and/or high anxiety measures (Greenberg et al.
2000; Katsuragl et al. 1999; Osher, Hamer, and Benjamin 2000; Ricketts et al.
1998). Two further studies showed mixed findings (Gelernter, Kranzler, Coccaro,
Siever, and New 1998; Rosenthal et al. 1998). Nine studies, however, found no
association (Ball et al. 1997; Deary et al. 1999; Ebstein et al. 1997; Flory et
al. 1999; Gustavsson et al. 1999; Hamilton et al. 1999; Herbst, Zonderman,
McCrae, and Costa 2000; Jorm et al. 2000; Kumakiri et al. 1999). Thus, as in
many instances in this complex new area, the real significance of the short allele
of 5-HTT is not known.
 A Psychosocial Model of the Development of Mentalization / 117

behaviorally precocious a n d u n u s u a l l y secure. W h e n moved into

a larger social group, t h e y were particularly a d e p t a t recruiting
and retaining o t h e r g r o u p m e m b e r s a s allies, a n d t h e y rose to
and m a i n t a i n e d high positions in t h e d o m i n a n c e h i e r a r c h y
(Suomi 1991). T h e m a t e r n a l style of high-reactive females raised
by n u r t u r a n t m o t h e r s reflected t h e style of their n u r t u r a n t fos-
t e r - m o t h e r s r a t h e r t h a n their own t e m p e r a m e n t . T h u s t h e b e n -
efits of n u r t u r a n t foster-mothering c a n evidently be t r a n s m i t t e d
to t h e next generation, even t h o u g h t h e m o d e of t r a n s m i s s i o n is
nongenetic in n a t u r e (Suomi a n d Levine 1998). Calm m o t h e r i n g
of these genetically vulnerable individuals n o t only will reduce
the risk associated with t h i s genotype, b u t t h e r e is some evi-
dence t h a t if t h e y receive particularly sensitive caregiving, t h e s e
individuals will develop special capacities of resilience.
A further e x a m p l e of t h e s a m e kind of g e n e - e n v i r o n m e n t
interaction c o m e s from o u r collaborative s t u d i e s a t t h e Men-
ninger Clinic (Fonagy, Stein, a n d White 2001). We h a v e focused
on the alleles o f t h e second d o p a m i n e receptor (DRD2). T h e A l or
A1A2 allele exists in only a minority of n o r m a l subjects (usually
no more t h a n 20%). Its prevalence h a s b e e n s h o w n to be elevated
in a n u m b e r of clinical g r o u p s , particularly t h o s e with p r o b l e m s
of alcoholism (Blum et al. 1990; Gelernter, Goldman, a n d Risch
1993), gambling (Comings, M u h l e m a n , a n d Gysin 1996), s u b -
stance m i s u s e (Uhl, Blum, Noble, a n d S m i t h 1993), a n d eating
disorders (Comings 1997). A c c o u n t s of t h e s e findings mostly
invoke t h e observations of r e d u c e d n u m b e r s of D2 receptors. We
have b e e n able to replicate t h e s e r e s u l t s in a t r a u m a t i z e d border-
line-personality-disordered s a m p l e a t t h e Menninger Clinic,
m a n y of w h o m n a t u r a l l y h a v e d e p e n d e n c y a n d other similar
problems. As p a r t of a s t u d y o n t h e effect of early t r a u m a , we a r e
collecting retrospective information on childhood t r a u m a u s i n g
Toni Bifulco's Childhood Experience of Care a n d A b u s e I n s t r u -
ment (Bifulco, Brown, a n d Harris 1987). Concurrently, childhood
data were collected on a s u b s t a n t i a l s u b g r o u p of t h e individuals
assessed, a s t h e s e individuals a t t e n d e d t h e Menninger t h e r a p e u -
tic preschool.
A very preliminary analysis of a relatively s m a l t s a m p l e [n =
78) suggests t h a t t h e A l allele m a y b e a biological m a r k e r for t h e
effect of certain t y p e s of t r a u m a . Based on largely retrospective
118 / Theoretical Perspectives

information, we found t h a t t h e i m p a c t of t r a u m a o n a d u l t per-

sonality functioning a s m e a s u r e d by J o n a t h a n Hill a n d col-
leagues' APFA m e a s u r e (Hill, Harrington, Fudge, Rutter, a n d
Pickles 1989) w a s restricted to t h e s u b g r o u p w h o h a d t h e A l
allele. However, t h e effect a p p e a r e d to be limited to certain k i n d s
of interpersonal t r a u m a , namely physical a n d sexual a b u s e . This
is a very preliminary analysis on quite a small sample, so t h e s e
findings might very well n o t hold. It is introduced h e r e merely to
illustrate a specific type of g e n e - e n v i r o n m e n t interaction. It is,
however, consistent with t h e mixed evidence t h a t sometimes
(but n o t invariably) links DRD2*A1 with susceptibility to t r a u m a
(Comings et al. 1991, 1999). T h e implication is t h a t early t r a u m a
activates t h e gene, which, t h r o u g h r e d u c i n g t h e capacity for
interpersonal adaptation, m a k e s t h e individual vulnerable to
later t r a u m a t a . We have some evidence c o n s i s t e n t with this
hypothesis. As p a r t of o u r b a t t e r y we u s e d Simon B a r o n - C o h e n ' s
"reading t h e m i n d in t h e eyes" t e s t (Baron-Cohen 2000). We
found t h a t subjects with t r a u m a t i c experiences were less sensi-
tive on t h i s test. F u r t h e r m o r e , w h e n we controlled for mentaliza-
tion u s i n g t h e eyes t e s t score a s a covariate, t h e previously
observed g e n e - e n v i r o n m e n t interaction d i s a p p e a r e d . This im-
plies t h a t sensitivity to m e n t a l s t a t e s m a y indeed h a v e b e e n the
mediator of t h e selective effect of t r a u m a . Those with t h e A l
allele, either a s a c o n s e q u e n c e of t r a u m a or associated with a
genetic predisposition, h a d less interpersonal sensitivity a n d
showed greater t r a u m a - r e l a t e d i m p a i r m e n t in social functioning.
T h e A l allele is probably a m a r k e r for low d o p a m i n e t r a n s -
porter binding, w h i c h predicts, a m o n g o t h e r things, a detached
personality in h e a l t h y subjects (Laakso et al. 2000), vulnerability
to relapse in alcoholics (Guardia et al. 2000), a n d social phobia
(Schneier et al. 2000). It is a t least possible to a r g u e t h a t t h e D2
alleles provide a m a r k e r for a certain k i n d of interpersonal
vulnerability. In o u r sample, t h e A l allele was, in t h e a b s e n c e of
t r a u m a , coupled with significant elevation of personality dys-
function, b u t dysfunction associated with t r a u m a w a s evident in
t h e p r e s e n c e of t r a u m a . It is either t r a u m a t h a t leads to the
expression of t h e gene t h a t generates pathology, p e r h a p s via the
reduction of D2 receptors, or else t h e other alleles m a r k a n
individual's capacity to metabolize early t r a u m a t i c experience
 A Psychosocial Model ofthe Development of Mentalization / 119

adequately a n d avoid t h e diverse forms of sequelae t h a t m i g h t be

expected to follow early t r a u m a t i z a t i o n . It should be e m p h a s i z e d
t h a t t h e s e d a t a come from t h e analysis of pilot d a t a from a n
ongoing study; t h e u l t i m a t e r e s u l t s might n o t s u p p o r t t h e s e
provisional conclusions.
Finally, a n i m p o r t a n t r e s u l t h a s recently b e e n published from
the B u d a p e s t I n f a n t - P a r e n t S t u d y (Lakatos et al. 2000). T h e s e
workers found a n association between t h e DRD4 receptor III
exon p o l y m o r p h i s m a n d disorganized a t t a c h m e n t classification
in 12-month-old infants. Over t h e years, considerable evidence
h a s linked behavioral p r o b l e m s in b o t h children a n d a d u l t s with
the 7-repeat allele of t h e DRD4 gene. In particular, ADHD h a s
been implicated (Faraone et al. 1999; LaHoste et al. 1996; Rowe
et al. 1998; Smalley et al. 1998; S w a n s o n et al. 1998), a l t h o u g h
not all s t u d i e s c o n c u r (Castellanos et al. 1998). T h e review by
S w a n s o n a n d colleagues (Swanson et al. 2000) confirmed t h e
likely role of t h e 7-repeat allele of t h i s gene in m a k i n g t h e
postsynaptic receptor subsensitive, t h u s possibly r e d u c i n g t h e
efficiency of n e u r a l circuits for behavior inhibition. Comings et
al. (1999) report findings related to impulsive, compulsive, addic-
tive behaviors t h a t indicate a greater complexity t h a n does a sole
focus on t h e 7- v e r s u s n o n - 7 alleles o f t h e DRD4 gene. In view of
recent findings, w h i c h h a v e linked disorganized a t t a c h m e n t in
infancy to clinical conditions in middle childhood, it m a y be
particularly i m p o r t a n t t h a t in t h i s s t u d y 71% of t h e infants
classified a s disorganized were found to h a v e a t least one 7-
repeat allele, in c o n t r a s t with only 29% of t h e nondisorganized
group. T h u s infants classified a s disorganized were more t h a n
four times m o r e likely to be carrying t h i s allele.
This finding is c o n s i s t e n t with observations t h a t neurological
(Pipp-Siegel, Siegel, a n d D e a n 1999) a n d n e o n a t a l (Spangler,
Fremmer-Bombik, a n d G r o s s m a n n 1996) behavioral organiza-
tion m a y anticipate a disorganized a t t a c h m e n t classification. It
might a t first sight seem a t odds, however, with t h e classical
observation t h a t disorganized infant a t t a c h m e n t w a s linked to
unresolved loss or t r a u m a in t h e m o t h e r (Lyons-Ruth a n d
Jacobovitz 1999; Main a n d Hesse 1990). A r e c e n t prospective
study led by Pat H u g h e s confirmed t h a t m o t h e r s with a history
of perinatal b e r e a v e m e n t were far more likely to h a v e disorgan-
 120 / Theoretical Perspectives

ized infants t h a n were controls. W h e r e a s a l m o s t 4 5 % of t h e

m o t h e r s who h a d lost their last b a b y d u r i n g p r e g n a n c y h a d
infants classified a s disorganized a t 1 year, only 2 0 % of t h e
control m o t h e r s m a t c h e d for age, S E S (socioeconomic status);
a n d education did so. Adult a t t a c h m e n t interviews collected
before t h e birth of t h e child picked u p t h e risk for disorganiza-
tion. Lack of resolution of m o u r n i n g m e d i a t e s t h e association of
stillbirth experience a n d disorganization of t h e "replacement
infant" in t h e S t r a n g e Situation.
B u t only 62% of t h e m o t h e r s with unresolved AAI classifica-
tion h a d infants classified a s disorganized, a l t h o u g h specificity
w a s relatively high (over 80% of disorganized infants h a d u n r e -
solved mothers). It s e e m s t h a t lack of resolution of m o u r n i n g
m a y be a n e c e s s a r y b u t n o t a sufficient condition for disorgani-
zation. Since only a third of t h e children in t h e B u d a p e s t s t u d y
with t h e 7-repeat allele showed disorganized a t t a c h m e n t , check-
ing for t h e p r e s e n c e of t h e 7-repeat allele might, of course,
explain t h e discrepancy. It is possible t h a t t h e a b n o r m a l i t i e s in
i n f a n t - m o t h e r interaction; a s s u m e d to be associated with lack of
resolution of bereavement, m a y i m p a c t m o r e on individuals
whose mesolimbic d o p a m i n e s y s t e m is functioning less effi-
ciently, for w h i c h t h e 7-repeat allele of t h e D4 receptor m a y be a
m a r k e r . T h e mesolimbic d o p a m i n e s y s t e m h a s b e e n proposed to
control behavior motivated by reward (Robbins a n d Everitt
1999), a n d less sensitive D4 d o p a m i n e receptors (Van Tol et al.
1992) could further distort t h e signal value of t h e m o t h e r ' s
response. The review by S w a n s o n a n d colleagues (Swanson et al.
2000) s u g g e s t s t h a t d o p a m i n e underactivity c o m p r o m i s e s atten-
tional systems, w h i c h might exaggerate t h e i m p a c t of s u b t l e
a n o m a l i e s o f t h e m o t h e r ' s behavior in relation to h e r infant (e.g.,
m o m e n t a r y dissociation, frightened or frightening behavior,
etc.—see Solomon a n d George 1999). This is clearly speculative,
b u t it is a readily testable h y p o t h e s i s t h a t is in line with t h e
general interactional model t h a t we propose.
To s u m m a r i z e , we h a v e identified t h r e e i n s t a n c e s w h e r e d a t a
from molecular biology might be illuminated by s t u d y of t h e
early family environment, particularly p a r e n t i n g a n d a t t a c h -
m e n t . In one case, lack-of a d e q u a t e p a r e n t i n g w a s clearly linked
to t h e p e n e t r a t i o n of o n e of t h e alleles of t h e 5-HTT gene, c a u s -
 A Psychosocial Model of the Development of Mentalization / 121

ing dysfunction in serotonergic activity. In t h e second case,

t h o s e w h o s e experience 1 included psychological (and physical)
a b u s e a n d t h e A l allele of t h e D2 gene showed t h e g r e a t e s t
personality dysfunction. In t h e third case, a p o s t t r a u m a t i c s t a t e
in t h e m o t h e r m i g h t possibly interact with a n o t h e r d o p a m i n e
receptor, c a u s i n g dysfunctional a t t a c h m e n t organization a n d
s u b s e q u e n t psychological d i s t u r b a n c e . All t h e s e findings a r e
r a t h e r t e n u o u s a t t h e m o m e n t , b u t all t h r e e are consistent with
t h e h y p o t h e s i s t h a t early experience with t h e object is formative,
even for genetically determined predisposition t h r o u g h t h e trig-
gering of gene expression. T a k e n together, t h e y suggest quite a
fruitful line of investigation, which, given t h e relative facility
with w h i c h s a m p l e s c a n b e collected a n d analyzed, might be-
come a n i m p o r t a n t a d j u n c t to m o s t of o u r work in developmen-
tal psychopathology.

The G e n e s i s of an Appraisal M e c h a n i s m

So far, we h a v e a r g u e d t h a t t h e i m p o r t a n c e of family environ-

m e n t m a y h a v e b e e n u n d e r e s t i m a t e d in behavioral genetics re-
search, for methodological a n d c o n c e p t u a l a s well a s empirical
r e a s o n s . We h a v e also tried to c o n s t r u c t a primafacie case for a
r e p r e s e n t a t i o n a l s y s t e m t h a t forms a n active filter between t h e
genotype a n d t h e p h e n o t y p e . In o t h e r words, t h e m e n t a l pro-
cessing of experience is critical for t h e expression of genetic
material, a n d t h e r e i n lie s u b s t a n t i a l interactions between gene
a n d environment. We will n o w a r g u e t h a t t h e genesis of t h e
representational s y s t e m t h a t forms a n active filter between t h e
genotype a n d t h e p h e n o t y p e is intrinsically linked to t h e quality
of early object relationships. P e r h a p s m o r e t h a n s h a p i n g t h e
quality of s u b s e q u e n t relationships (for w h i c h evidence is lack-
ing), t h e early relationship e n v i r o n m e n t serves to equip t h e
individual with a processing system. T h e creation of this repre-
sentational s y s t e m is a r g u a b l y t h e m o s t i m p o r t a n t evolutionary
function for a t t a c h m e n t to a caregiver. Adopting t h i s perspective
helps to r e d r e s s t h e prevailing b i a s a g a i n s t t h e centrality of t h e
family a s t h e major force in socialization, b u t it also shifts t h e
e m p h a s i s from c o n t e n t of experience to psychological s t r u c t u r e
122 / Theoretical Perspectives

or m e n t a l m e c h a n i s m a n d involves e x p a n d i n g on c u r r e n t ideas
of t h e evolutionary function of a t t a c h m e n t .
J o h n Bowlby, a major Darwin scholar (Bowlby 1991), w a s
impressed by t h e obvious selection a d v a n t a g e s of infant protest
a t separation—that is, protection from predation (Bowlby 1969).
Given t h a t phylogenetically a n d ontogenetically infancy is a pe-
riod of extreme risk, it is u n a r g u a b l e t h a t n a t u r a l selection would
favor individuals with a capacity for a t t a c h m e n t . There h a s b e e n
a revolution in evolutionary theory since Bowlby's time. We now
realize t h a t "survival of t h e fittest" c a n n o t g u a r a n t e e t h e n a t u r a l
selection of a behavior. Only t h e reproduction of genetic material
c a n achieve t h i s (W. D. Hamilton 1964). This is t h e theory of
inclusive fitness. One does n o t need to survive a n d r e p r o d u c e
oneself in order for one's g e n e s to be replicated. For example,
some o r g a n i s m s will forgo r e p r o d u c t i o n in order to e n s u r e t h e
reproductive potential of their genetically close relatives. The
concept of "inclusive fitness" places a t t a c h m e n t theory a t t h e
center stage of evolutionary sociobiology a s a key behavioral
m e c h a n i s m mediating t h e e s t a b l i s h m e n t of genetic proximity, for
a t t a c h m e n t is t h e p r o c e s s t h a t e n s u r e s t h a t we k n o w whose
survival will a d v a n t a g e t h e reproduction of o u r genes. Of course,
it m a y have additional evolutionary functions. F r e u d ' s (1900a)
principle of multiple d e t e r m i n a t i o n w o r k s in evolutionary theory
j u s t a s m u c h a s in d r e a m Interpretation a n d s y m p t o m genera-
tion. It is possible t h a t a t t a c h m e n t m a r k s individuals with w h o m
we should not m a t e b e c a u s e of t h e biological r i s k s associated
with interbreeding a n d incest. Adult a t t a c h m e n t m a y also be a
m a r k e r for reciprocal altruism. Altruism a n d cooperatlveness
(Axelrod 1984; Trivers 1971)—the "quid-pro-quo" strategy of
helping n o n - k i n if, a n d only if, they h a v e d o n e s o m e t h i n g for
one—might also be u n d e r p i n n e d by t h e m e c h a n i s m of attach-
m e n t . A t t a c h m e n t is likely to minimize t h e adverse effects of
"cheaters"—individuals w h o do n o t reciprocate equitably in
g r o u p s over time a n d to w h o m we are unlikely to b e c o m e at-
tached. This would be a good example of a further interesting
facet of evolution: how a m e c h a n i s m t h a t evolved for one p u r p o s e
(the protection of t h e vulnerable infant) m a y be p u t to good
biological u s e in t h e context of t h e adaptive p r o b l e m s of s u b s e -
q u e n t developmental p h a s e s . B u t all t h e s e potential biological
 A Psychosocial Model ofthe Development of Mentalization / 123

functions would apply a s readily to a n i m a l models of a t t a c h m e n t

a s to t h e h u m a n infant. If t h e biological function of a t t a c h m e n t is
to be a pillar in o u r a r g u m e n t for t h e i m p o r t a n c e of parenting, w e
need to restrict ourselves to uniquely h u m a n capacities.
The generally recognized c o m p o n e n t s of a t t a c h m e n t be-
haviors t h a t serve to e s t a b l i s h a n d m a i n t a i n proximity are: {a)
signals t h a t d r a w t h e caregivers to their children (such a s smil-
ing), (b) aversive behaviors (such a s crying), w h i c h perform t h e
s a m e function, a n d (c) skeletal-muscle activity (primarily loco-
motion), w h i c h brings t h e child to t h e caregiver. B u t t h e r e is a
fourth c o m p o n e n t t h a t provides a better evolutionary rationale
for t h e entire enterprise of h u m a n a t t a c h m e n t , going beyond t h e
issue of physical protection: (d) according to Bowlby, a t a b o u t
the age of 3 y e a r s behaviors signifying a goal-corrected p a r t n e r -
ship begin to emerge. T h e central psychological p r o c e s s e s for
mediating goal-corrected p a r t n e r s h i p s a r e t h e internal working
models.
Bowlby's original concept h a s b e e n thoughtfully elaborated by
some of t h e g r e a t e s t m i n d s in t h e a t t a c h m e n t field (Bretherton
1991b; B r e t h e r t o n a n d M u n h o l l a n d 1999; Crittenden 1990.
1994; M. Main 1991; Main et al. 1985; Sroufe 1990, 1996), a n d
no a t t e m p t to duplicate t h i s will be u n d e r t a k e n here. However, it
might be helpful to s u m m a r i z e t h e four representational s y s t e m s
t h a t a r e implied in t h e s e reformulations: (a) expectations of
interactive a t t r i b u t e s of early caregivers created in t h e first year
of life a n d s u b s e q u e n t l y elaborated, (b) event r e p r e s e n t a t i o n s by
which general a n d specific memories of a t t a c h m e n t - r e l a t e d ex-
periences are encoded a n d retrieved, (c) autobiographical memo-
ries by w h i c h specific events are conceptually connected b e c a u s e
of their relation to a c o n t i n u i n g p e r s o n a l narrative a n d develop-
ing self-understanding, a n d (d) u n d e r s t a n d i n g of t h e psychologi-
cal characteristics of other people (inferring a n d attributing
causal motivational m i n d s t a t e s s u c h a s desires a n d emotions
and epistemic m i n d s t a t e s s u c h a s i n t e n t i o n s a n d beliefs) and
differentiating these from those ofthe self. T h u s a key develop-
mental a t t a i n m e n t of t h e i n t e r n a l working model is t h e creation
of a processing s y s t e m for t h e self (and significant others) in
terms of a set of s t a b l e a n d generalized intentional a t t r i b u t e s ,
s u c h a s desires, emotions, intentions, a n d beliefs inferred from
124 / Theoretical Perspectives

recurring invariant p a t t e r n s in t h e history of previous interac-

tions. The child comes to be able to u s e t h i s r e p r e s e n t a t i o n a l
system to predict t h e other's or t h e self s behavior in conjunction
with local, m o r e t r a n s i e n t intentional s t a t e s inferred from a
given situation.
Classically, in a t t a c h m e n t theory this p h a s e c h a n g e from
behavior to r e p r e s e n t a t i o n is generally regarded a s a modifica-
tion of t h e a t t a c h m e n t s y s t e m propelled by cognitive develop-
m e n t (Marvin a n d Britner 1999). O u r contention h e r e is the
reverse: r a t h e r t h a n seeing t h e biological role of a t t a c h m e n t
shifting ontogenetically a s a c o n s e q u e n c e of other, biologically
driven m a t u r a t i o n a l changes, we propose t h a t a major selective
advantage conferred by a t t a c h m e n t to h u m a n s w a s t h e oppor-
t u n i t y it afforded for t h e development of social intelligence
a n d m e a n i n g - m a k i n g . The capacity for "interpretation," which
Bogdan defined a s "organisms m a k i n g s e n s e of e a c h other in
contexts where t h i s m a t t e r s biologically" (1997, p. 10), b e c o m e s
uniquely h u m a n w h e n o t h e r s a r e engaged "psychologically in
s h a r i n g experiences, information a n d affects" (p. 94). T h e capac-
ity to interpret h u m a n behavior—to m a k e s e n s e of e a c h other—
requires t h e intentional s t a n c e : "treating t h e object w h o s e be-
havior you w a n t to predict a s a rational agent with beliefs a n d
desires" (Dennett 1987, p. 15).
T h e capacity for interpretation in psychological terms—let u s
call t h i s t h e "Interpersonal Interpretive Mechanism," or IIM—is
n o t j u s t a generator or mediator of a t t a c h m e n t experience; it is
also a p r o d u c t of t h e complex psychological p r o c e s s e s engen-
dered by close proximity in infancy to a n o t h e r h u m a n being—the
primary object or a t t a c h m e n t figure. It is n o t Bowlby's TWM; it is
j u s t a p a r t of t h e IWM (Bowlby, 1980) a n d p e r h a p s Kernberg's
self-object-affect triad (1983). It does n o t c o n t a i n representa-
tions of experiences a n d is n o t a repository of p e r s o n a l encoun-
ters with t h e caregiver. Rather, it is a m e c h a n i s m for processing
new experiences, m o r e like Bion's (1962a) a l p h a function. The
IIM is closely related to t h e notion of a "theory of mind"—the
ability to a t t r i b u t e i n d e p e n d e n t m e n t a l s t a t e s to o t h e r s in order
to explain a n d predict their behavior (Leslie 1987). Earlier in this
volume, we introduced t h e concept of reflective function a n d
mentalization (chapter 1) to b r o a d e n t h e r a t h e r n a r r o w scope

a
 A Psychosocial Model ofthe Development of Mentalization / 125

a n d operationalization of t h e theory-of-mind c o n s t r u c t . We see

the IIM a s a n overarching hypothetical n e u r a l s t r u c t u r e , a pro-
cessing s y s t e m for social information t h a t underlies reflective
function or mentalization b u t m a y h a v e m a n y functions beyond
these. In t h e p r e s e n t c h a p t e r , we u s e IIM a s t h e a s s u m e d n e u r a l
m e c h a n i s m t h a t i n t e r a c t s with t h e genotype to e n h a n c e or re-
d u c e t h e likelihood of genetic expression. In later c h a p t e r s , we
restrict ourselves a l m o s t entirely to psychological observations
a n d m a r k t h i s by u s i n g t h e t e r m s "mentalization" or "reflective
function"—the latter w h e n referring to mentalization a s it is
operationalized in o u r work. We a s s u m e t h a t t h e quality of
functioning of t h e IIM is reflected in t h e quality of mentalization.
In c h a p t e r 4 we outline how t h e development of t h e IIM is
facilitated by sensitive a n d a t t u n e d early care, a n d c h a p t e r 5
gives a c o m p r e h e n s i v e a c c o u n t of t h e ontogenesis of mentali-
zation a s it relates to t h e formation of t h e self.
The IIM m a y b e a final step in t h e t r a n s c r i p t i o n of genetic
influence into a p a t t e r n of behavior, in a way a n a l o g o u s to RNA.
The interpretive m e c h a n i s m encodes genetic information in t h e
form of biases, b u t , we would s u s p e c t , of a very specific a n d
situational c h a r a c t e r . Interpreting social behavior in one context
may correlate poorly with u n d e r s t a n d i n g of a n o t h e r . For exam-
ple, from t h e work of Mary Target with Arietta Slade a n d h e r
colleagues on t h e PDI (Parents Development Interview—Slade,
Bernbach, Grienenberger, Wohlgemuth-Levy, a n d Locker, u n -
published m a n u s c r i p t ) , we a r e finding t h a t p a r e n t a l reflective
function is specific to e a c h p a r e n t - c h i l d relationship. In o u r twin
study, p a r e n t s ' r e p r e s e n t a t i o n of e a c h twin w a s independently
predictive of S t r a n g e Situation observation. The IIM, or a m e c h a -
nism like it, is responsible for t h e m o d e r a t i o n of genetic influence
by modifying t h e child's perception of h i s social environment.
T h u s given a genetic predisposition for antisocial behavior, for
example, positive behaviors in t h e family c a n protect t h e child
from becoming antisocial (Reiss et al. 2000), b e c a u s e s u c h posi-
tive behaviors e n h a n c e t h e functioning of t h e interpersonal
interpretive m e c h a n i s m in t h a t child, which, in t u r n , h e l p s in
generating less malevolent interpersonal attributions. Of course,
s u c h w a r m t h may, in t u r n , be t h e c o n s e q u e n c e of inherited
characteristics in t h e child, s u c h a s physical attractiveness, easy
126 / Theoretical Perspectives

t e m p e r a m e n t , a n d so on. O u r proposal for e n v i r o n m e n t a l influ-

ence does n o t entail a r e t u r n to naive e n v i r o n m e n t a l i s m .

T h e O n t o g e n e s i s o f t h e IIM

How is t h e IIM created o u t of t h e s e c u r e b a s e ? Clearly there

m u s t b e biological p r e p a r e d n e s s , b u t in o u r view t h i s is n o t
separable from, t h e infant's experience o f t h e caregiving environ-
m e n t . In a n s w e r i n g t h i s question we are drawing on George
Gergely a n d J o h n W a t s o n ' s model (Gergely a n d W a t s o n 1996,
1999). A core proposition in this book is t h e rejection of t h e
notion t h a t t h e c o n s c i o u s a p p r e h e n s i o n of o u r m i n d s t a t e s
through, introspection m i g h t be a basic, direct, a n d probably
prewired ability of o u r mind. We do n o t believe t h a t knowledge of
t h e self a s a m e n t a l agent is innately given. Rather, we see it a s a
developing or c o n s t r u c t e d capacity t h a t evolves o u t of t h e earli-
est relationships. In c h a p t e r 4 t h e developmental roots of o u r
model of t h e a p p r e h e n s i o n of emotional s t a t e s is described in
full, a n d in c h a p t e r 5 some of t h e p r o b l e m s of t h e nativist
intersubjective position are critically considered. In t h e c u r r e n t
chapter, we anticipate t h e s e a r g u m e n t s with a brief outline of
t h e ontogenetic model a n d focus on t h e b r o a d e r implications of
t h e a s s u m p t i o n of a n interpersonal interpretive processing sys-
t e m t h a t m o d e r a t e s genetic influences on personality.
O u r core idea is t h a t t h e a t t a c h m e n t context provides t h e
setting in w h i c h t h e infant c a n develop a sensitivity to self-states,
t h r o u g h w h a t Gergely h a s termed "psycho-feedback" or social
biofeedback—a m e c h a n i s m t h a t is fully described in c h a p t e r 4.
The child acquires t h i s capacity for sensitivity by developing a
second-order symbolic r e p r e s e n t a t i o n a l s y s t e m for motivational
a n d epistemic m i n d states. W h a t initiates t h e development of
t h i s r e p r e s e n t a t i o n a l s y s t e m is t h e internalization of t h e moth-
er's mirroring r e s p o n s e of t h e infant's d i s t r e s s (caregiving
behavior), w h i c h c o m e s to r e p r e s e n t a n i n t e r n a l state. T h e moth-
er's e m p a t h i c emotion provides t h e infant with feedback on his
emotional state. T h e infant internalizes t h e m o t h e r ' s e m p a t h i c
expression by developing a s e c o n d a r y r e p r e s e n t a t i o n of h i s emo-
tional state, with t h e m o t h e r ' s e m p a t h i c face a s t h e signifler a n d
 A Psychosocial Model ofthe Development of Mentalization / 127

h i s own emotional a r o u s a l a s t h e signified. T h e m o t h e r ' s expres-

sion t e m p e r s emotion to t h e extent t h a t it is s e p a r a t e a n d
different from t h e p r i m a r y experience, a l t h o u g h crucially it is
recognized n o t a s t h e m o t h e r ' s experience, b u t a s a n organizer of
a self-state. It is t h i s "intersubjectivity" t h a t is t h e bedrock o f t h e
intimate connection between a t t a c h m e n t a n d self-regulation.
As s h o w n in c h a p t e r 5. however, intersubjectivity in t h i s
context m a y be a m i s n o m e r . At t h i s stage t h e infant is u n a w a r e
t h a t he is seeing t h e other's subjective state. It is likely t h a t t h e
infant does n o t yet k n o w t h a t o t h e r s h a v e internal feelings. At
this level of h u m a n proximity t h e other's subjective s t a t e is
automatically referred to t h e self. In infancy t h e contingent
responding of t h e a t t a c h m e n t figure does far m o r e t h a n provide
r e a s s u r a n c e a b o u t a protective presence. It is t h e principal
m e a n s by w h i c h we acquire u n d e r s t a n d i n g of o u r own internal
states, w h i c h is a n i n t e r m e d i a t e step in t h e acquisition of a n
u n d e r s t a n d i n g of o t h e r s a s psychological entities—the inten-
tional s t a n c e . We believe t h a t w h e n relational a n a l y s t s s u c h a s
the brilliant late S t e p h e n Mitchell (2000) describe intersubjectiv-
ity in t h e context of therapy, t h e y a r e invoking t h i s m e c h a n i s m .
In t h e first y e a r t h e infant only h a s p r i m a r y a w a r e n e s s of
being in a p a r t i c u l a r internal, emotional state. S u c h a w a r e n e s s
is n o n c a u s a l or e p i p h e n o m e n a l in t h a t it is n o t p u t to a n y
functional u s e by t h e system. It is in t h e p r o c e s s of psycho-
feedback b e t w e e n infant a n d m o t h e r t h a t t h e s e internal experi-
ences a r e m o r e closely a t t e n d e d to, evolve a functional role (a
signal value), a n d acquire a function in m o d u l a t i n g or inhibiting
action. T h u s it is a t t a c h m e n t p r o c e s s e s t h a t e n s u r e t h e move
from primary a w a r e n e s s of i n t e r n a l s t a t e s to functional aware-
ness. In functional a w a r e n e s s a feeling of a n g e r m a y be u s e d to
simulate a n d so to infer t h e other's corresponding m e n t a l state.
This is achieved n o t t h r o u g h reflection b u t by action: t h e child
"knows" t h a t acting in a p a r t i c u l a r way will r e s u l t in a specified
outcome b u t does n o t n e e d to—or is n o t yet able to—make t h e
further inference t h a t t h e o u t c o m e is a c o n s e q u e n c e of t h e
internal s t a t e h e generated in t h e object. Functional a w a r e n e s s
of internal s t a t e s c a n also be u s e d to serve a signal value to
direct action. T h e next level of a w a r e n e s s is reflective a w a r e n e s s ,
where t h e individual c a n m a k e a c a u s a l m i n d s t a t e become t h e
128 / Theoretical Perspectives

object of attention w i t h o u t it c a u s i n g action. W h e r e a s functional

a w a r e n e s s is intrinsically coupled with action, reflective aware-
n e s s is s e p a r a t e from it. It h a s t h e capacity to move away from
physical reality a n d m a y be felt to be n o t for real. A final level is
autobiographical, where t h e child is able to place r e c o r d s of
experiences i m b u e d with psychological s t a t e s into a s e q u e n c e
t h a t r e p r e s e n t s h i s history a s a n individual. T h e s e s t a g e s of the
development of self a s agent a r e detailed in c h a p t e r 5.
Many s t u d i e s provide evidence c o n s i s t e n t with t h i s model (see
c h a p t e r s 1 a n d 5). For example, a s t u d y m e n t i o n e d earlier
showed t h a t t h e rapid soothing of distressed 6 - m o n t h - o l d s could
be predicted on t h e b a s i s of ratings of emotional c o n t e n t of the
m o t h e r ' s facial expression d u r i n g t h e p r o c e s s of soothing: m o t h -
ers of rapid r e s p o n d e r s showed s o m e w h a t m o r e fear, s o m e w h a t
less joy, b u t m o s t typically a r a n g e of other affects in addition to
fear a n d s a d n e s s . Mothers of rapid r e s p o n d e r s were far more
likely to manifest multiple affect s t a t e s (complex affects). We
interpreted t h e s e r e s u l t s a s s u p p o r t i n g Gergely a n d W a t s o n ' s
notion of t h e m o t h e r ' s face being a s e c o n d a r y r e p r e s e n t a t i o n of
t h e infant's experience—the s a m e , a n d yet n o t t h e s a m e . This is
functional a w a r e n e s s with t h e capacity to m o d u l a t e affect states.
A further set of s t u d i e s performed by Gergely a n d h i s col-
leagues in B u d a p e s t a s well a s o u r laboratory in London a n d
with a n ongoing replication in Topeka, Kansas, explored 1-year-
olds' u n d e r s t a n d i n g of conflicting affect (Koos, Gergely, Gervai,
a n d Toth 2000). In one study, 1 2 - m o n t h a t t a c h m e n t classifica-
tion—particularly s e c u r e a n d disorganized—was found to b e pre-
dicted by infant behavior a t 6 . 5 m o n t h s in a modified still
p a r a d i g m (Koos et al. 2000). T h e p a r a d i g m involves t h e m o t h e r
being i n s t r u c t e d according to t h e still-face protocol b u t facing a
mirror, w h e r e t h e infant h a s a choice between looking a t t h e
m o t h e r ' s face or looking a t a perfectly contingent image (them-
selves). Infants classified a s securely a t t a c h e d engaged six
m o n t h s later in significant a m o u n t s of active testing of their
mirror self-image only w h e n their m o t h e r b e c a m e temporarily
inaccessible.(the still-face period). In c o n t r a s t , b a b i e s w h o went
on to manifest disorganized a t t a c h m e n t six m o n t h s later were
d r a w n to t h e image of their fully contingent self m o v e m e n t s
t h r o u g h o u t t h e laboratory testing. Interestingly, t h e Koos et al.
 A Psychosocial Model ofthe Development of Mentalization / 129

(2000) s t u d y also d e m o n s t r a t e d t h a t following t h e still-face pe-

riod t h e infants w h o engaged in m o r e contingency testing while
looking a t their self-image showed more positive affect following
the procedure. T h i s led to m o r e successful affect regulation in
disorganized infants t h a n in s e c u r e ones. Yet seeking for perfect
contingency in a t t e m p t s a t detecting internal s t a t e s in t h e con-
text of h u m a n interaction will b e of limited effectiveness in t h e
long r u n . It characterizes t h e dissociative style of attention or-
ganization t h a t is typical of disorganized a t t a c h m e n t .
In c h a p t e r 5 we consider t h e developmental move from a stage
when t h e infant s e e m s to prefer stimuli t h a t are perfectly contin-
gent with h i s a c t i o n s to a stage w h e n infants indicate greater
interest in stimuli t h a t only partially mirror their actions, which
are contingent b u t clearly n o t perfectly so. T h e preference for
perfect contingency t h a t characterizes t h e infant of less t h a n 5
m o n t h s clearly orients h i m toward h i s own physical self. It
establishes t h e p a r a m e t e r s of h i s body a s proprioceptive a n d
provides h i m with visual experiences t h a t are perfectly contin-
gent, a n d also contingent with r u d i m e n t a r y volitional s t a t e s
related to action. In c h a p t e r 5 we a r g u e t h a t t h e developmental
step entailed by t h e preference for high b u t imperfect contingen-
cies after t h e age of 5 m o n t h s t u r n s t h e h u m a n infant toward
social interaction with h i s a t t a c h m e n t figures. H u m a n beings are
incapable of r e s p o n d i n g with perfect contingency. An orientation
to t h e social world entails a greater tolerance for imperfect
contingencies, a s t h e caregiver fails to r e s p o n d to a high propor-
tion o f t h e infant's signals (Tronick 1989, 1998). Notwithstanding
the biological p r e p a r e d n e s s for imperfect contingency, t h e inter-
personal learning e n v i r o n m e n t within w h i c h t h e IIM c a n develop
probably r e q u i r e s a m i n i m u m level of contingent r e s p o n d i n g for
the experience of "nearly, but clearly not the same" to evolve—the
experience t h a t is u n d o u b t e d l y key to t h e creation of inter-
personal symbolic capacity. Disorganized a t t a c h m e n t p e r h a p s
m a r k s t h e historical a b s e n c e of a n interpersonal context t h a t
failed to m e e t t h e tolerance limits of t h e infant's capacity
to absorb imperfect contingency. T h u s , t h e experience of mis-
a t t u n e m e n t (or noncontingency), w h i c h c a u s e s all of u s to inter-
nalize a n "other within t h e self" (the p a r t of t h e self we will be
calling t h e "alien self*), goes in some c a s e s beyond w h a t t h e
 130 / Theoretical Perspectives

infant c a n tolerate a n d still feel a s e n s e of coherent, c o n t i n u o u s

identity. For m o s t u s , t h e experience of u n r e s p o n s i v e n e s s
or i n a p p r o p r i a t e r e s p o n s e c a n b e incorporated w i t h i n o u r self-
s t r u c t u r e t h r o u g h mentalization, w h i c h l e n d s a n illusion of co-
herence, normally t h r o u g h creating a narrative self. This coher-
ence b e c o m e s a functional reality a s we weave incompatible
experiences together into o n e identity. Arguably, t h e nagging
s e n s e of incongruity a n d of "loose ends" within t h e self-structure
supplies some of t h e motivation for seeking o u t further attach-
m e n t relationships t h r o u g h o u t life, in a s e a r c h for greater
integration a n d u n d e r s t a n d i n g . For o t h e r people, t h e alien expe-
rience within t h e self r e m a i n s a n inassimilable core t h a t creates
a n even more powerful n e e d for integration t h r o u g h later attach-
m e n t relationships b u t t h a t also gets in t h e w a y of forming a n d
m a i n t a i n i n g s u c h relationships. The vulnerability of reflective
function m a y t h e n be c o m p o u n d e d by later a t t a c h m e n t t r a u m a ,
which, in a n effort to restore a feeling of control, m a y lead to
identification w i t h t h e a b u s e r ' s s t a t e of m i n d . This s e q u e n c e is
explored further in c h a p t e r 10.

E v i d e n c e for t h e I n t e r p e r s o n a l
Interpretive Mechanism

Is t h e r e a n y evidence for a n IIM t h a t evolves o u t of t h e attach-

m e n t relationship, with its efficiency conditioned by a t t a c h m e n t
security?

1. There is unequivocal evidence from two d e c a d e s of longitudi-

n a l r e s e a r c h t h a t s e c u r e a t t a c h m e n t in infancy is strongly asso-
ciated with t h e precocious development of a r a n g e of capacities
t h a t d e p e n d on interpretive or symbolic skills, s u c h a s explora-
tion a n d play, intelligence a n d l a n g u a g e ability, ego resilience
a n d ego control; frustration tolerance, curiosity, self-recognition,
social cognitive capacities, a n d s o on. A t t a c h m e n t security fore-
s h a d o w s cognitive competence, exploratory skill, emotion regu-
lation, c o m m u n i c a t i o n style, a n d other o u t c o m e s . In o u r view,
this is n o t b e c a u s e of t h e general i m p a c t of a t t a c h m e n t security
 A Psychosocial Model of the Development of Mentalization / 131

on t h e child's self-confidence, initiative, ego functioning, or other

broader personality p r o c e s s e s b u t , r a t h e r , b e c a u s e a t t a c h m e n t
processes provide t h e key evolutionarily p r e p a r e d p a t h s for a n
interpersonal interpretive capacity to develop.
T h u s it is n o t t h e first a t t a c h m e n t s t h a t a r e formative, it is
not a t t a c h m e n t security per se t h a t predicts good outcome on
this dazzling a r r a y of m e a s u r e s ; r a t h e r , t h e features of t h e
interpersonal e n v i r o n m e n t t h a t generate a t t a c h m e n t security
d u r i n g t h e first y e a r of life also p r e p a r e t h e g r o u n d for t h e rapid
a n d c o m p e t e n t ontogenetic evolution of interpersonal interpreta-
tion. O n e problem in a t t e m p t i n g to trace some of t h e long-term
outcomes of s e c u r e a t t a c h m e n t in infancy h a s b e e n t h e appro-
priately conservative strategy of controlling for n u m e r o u s as-
pects of t h i s interpretive capacity. Controlling for verbal fluency
or even IQ removes a p a r t of t h e variability in which t h e a t t a c h -
m e n t relationship a r g u a b l y plays a c a u s a l role. B u t t h i s is a n
issue for a n o t h e r time.

2. A n u m b e r of specific findings in t h e literature link a t t a c h -

m e n t to t h e development of a n IIM. Laible a n d T h o m p s o n (1998)
reported t h a t securely a t t a c h e d children h a v e higher compe-
tence in u n d e r s t a n d i n g negative emotion. A u n i q u e s t u d y by
J u d e Cassidy a n d colleagues (Cassidy, Kirsh, Scolton, a n d Parke
1996) found t h a t securely a t t a c h e d k i n d e r g a r t e n e r s were less
likely to infer hostile i n t e n t in stories with a m b i g u o u s content.
This bias a p p e a r e d to m e d i a t e their superiority in sociometric
s t a t u s . In t h e London P a r e n t - C h i l d S t u d y Peter Fonagy, Miriam
and Howard Steele, a n d J u l i e t Holder (1997) reported precocious
performance o n theory-of-mind t a s k s a m o n g 5-year-olds with a
history of s e c u r e a t t a c h m e n t in infancy. This finding h a s also
been reported by other investigators since t h e n (Fonagy 1997;
Meins et al. 1998).

3. In a relatively full exploration of findings linking early at-

t a c h m e n t a n d later development, Ross T h o m p s o n concludes t h a t
"the s t r e n g t h of t h e relationship between infant security a n d
later socio-personality functioning is modest" (1999, p. 280). T h e
associations a r e stronger c o n t e m p o r a n e o u s l y t h a n t h e y a r e pre-
dictively. Within t h e context of t h e p r e s e n t theory, it is n o t t h e
 132 / Theoretical Perspectives

content of internal working models t h a t is likely to be deter-

mined by early experience; r a t h e r , t h e p r e s e n c e of a model or t h e
quality or r o b u s t n e s s of t h e model d e t e r m i n e s later socio-per-
sonality functioning. T h u s , a t t a c h m e n t classification might or
might n o t be stable from infancy t h r o u g h middle childhood to
adolescence. As prediction comes from t h e IIM, n o t from attach-
m e n t security per se, t h i s is of n o great concern.
T h e focus of s t u d y s h o u l d n o t b e a t t a c h m e n t security, w h i c h
achieved significance a s a correlate of t h e IIM b u t h a s little
stability a n d possibly little predictive value. Within t h e context of
t h e p r e s e n t theory, it is n o t t h e n a t u r e of self-other representa-
tions t h a t is t h o u g h t to b e determined by early experience.
Rather, t h e focus of t h e p r e s e n t enquiry is t h e extent to which
early experience m a y jeopardize t h e very existence of a s t r u c t u r e
to r e p r e s e n t object relationships, t h e processing skills required
to deal with interpersonal interaction, t h e r o b u s t n e s s of the
model, t h e extent to w h i c h t h i s interpretive m e c h a n i s m c a n
function u n d e r s t r e s s a n d p r o c e s s emotionally c h a r g e d informa-
tion, a n d so forth. The m e c h a n i s m of predictive significance is
t h e interpersonal interpretive m e c h a n i s m , w h i c h is a genetically
defined capacity t h a t is probably localized in t h e medial prefron-
tal cortex. S t u d i e s of p a t i e n t s with orbital-frontal a n d medial-
frontal lesions h a v e repeatedly suggested specific deficits in
t a s k s t h a t call for thinking a b o u t m e n t a l s t a t e s in o t h e r s (Chan-
n o n a n d Crawford 1999, 2000; S t u s s , Gallup, a n d Alexander
2001). Both PET (positron emission tomography) a n d fMRI (func-
tional magnetic r e s o n a n c e imaging) s t u d i e s in w h i c h subjects
were a s k e d to m a k e inferences a b o u t t h e m e n t a l s t a t e s of others
found activity associated with mentalizing in t h e medial prefron-
tal cortex. In addition, activity w a s elicited in t h e tempero-
parietal j u n c t i o n (Gallagher et al. 2000; Goel, Grafman, Sadato,
a n d Hallett 1995).
There is i n d e p e n d e n t evidence for t h e developmental vulner-
ability of t h i s s t r u c t u r e from PET-scan s t u d i e s of R o m a n i a n
a d o p t e e s who were deprived of t h e i n t e r p e r s o n a l experiences
t h a t we t h i n k m i g h t g e n e r a t e t h e IIM (B. Perry 1997). D a m a g e to
t h e s e frontal a r e a s (Adolphs, Tranel, Damasio, a n d D a m a s i o
1995; Alexander, S t u s s , a n d B e n s o n 1979; Brazzelli, Colombo,
Delia Sala, a n d Spinnler 1994; C h a n n o n a n d Crawford 1999,
 A Psychosocial Model ofthe Development of Mentalization / 133

2000; D a m a s i o 1994; Rogers et al. 1999) h a s b e e n consistently

associated with social a n d personality deficits t h a t a r e consist-
ent with t h e n o t i o n of t h e loss of interpersonal interpretive
capacity: impaired social j u d g m e n t s , impaired pragmatics, defi-
cient self-regulation, a n d impoverished association of social situ-
ations with p e r s o n a l affective m a r k e r s (e.g., Craik et al. 1999;
S t u s s 1983, 1991). Independently, we know, of course, t h a t t h e
a t t a c h m e n t classification of t h e s e a d o p t e e s r e m a i n s disorgan-
ized a t t h e age of 3 y e a r s a n d their social behavior is a b n o r m a l a t
age 8. We also h a v e evidence t h a t t h e mentalizing capacity of
individuals m a l t r e a t e d in early childhood c o n t i n u e s to have sig-
nificant limitations.

4. Myron Hofer's work with r o d e n t p u p s identified regulatory

interactions within t h e m o t h e r - i n f a n t relationship t h a t have
clear analogies to w h a t is proposed h e r e (Hofer 1995; Polan a n d
Hofer 1999). Hofer's w o r k over t h r e e d e c a d e s h a s revealed t h a t
the evolutionary survival value of staying close to a n d interacting
with t h e m o t h e r goes far beyond protection a n d m a y be ex-
p a n d e d to m a n y p a t h w a y s available for regulation of t h e infant's
physiological a n d behavioral system. Hofer's view is a n a l o g o u s to
ours in t h a t h e p r o p o s e s t h a t t h e a t t a c h m e n t "relationship pro-
vides a n o p p o r t u n i t y for t h e m o t h e r to s h a p e b o t h t h e developing
physiology a n d t h e behavior of h e r offspring t h r o u g h h e r pat-
terned interactions with h e r infant" (Polan a n d Hofer 1999,
p. 177). A t t a c h m e n t is n o t a n e n d in itself—it is a s y s t e m
adapted by evolution to fulfill key ontogenetic physiological a n d
psychological t a s k s .
Hofer's reformulation of a t t a c h m e n t in t e r m s of regulatory
processes, h i d d e n b u t observable within t h e p a r e n t - i n f a n t inter-
action, provides a very different way of explaining t h e r a n g e of
p h e n o m e n a u s u a l l y d i s c u s s e d u n d e r t h e h e a d i n g of a t t a c h m e n t .
The traditional a t t a c h m e n t model is clearly circular. T h e re-
sponse to s e p a r a t i o n is a t t r i b u t e d to t h e d i s r u p t i o n of a social
bond, t h e existence of w h i c h is inferred from t h e p r e s e n c e o f t h e
separation r e s p o n s e . We a r g u e t h a t w h a t is lost in "loss" is n o t
the b o n d b u t t h e o p p o r t u n i t y to g e n e r a t e a higher-order regula-
tory m e c h a n i s m : t h e m e c h a n i s m for a p p r a i s a l a n d reorganiza-
tion of m e n t a l c o n t e n t s . We conceptualize a t t a c h m e n t a s a
 134 / Theoretical Perspectives

process t h a t b r i n g s complex m e n t a l life into being from a com-

plex a n d a d a p t a b l e behavioral system. Some, b u t by n o m e a n s
all, s u c h m e n t a l function is u n i q u e to h u m a n s . T h e m e c h a n i s m s
t h a t generate t h e s e ( a t t a c h m e n t relationships) s h o w evolution-
ary continuity a c r o s s n o n h u m a n species. J u s t a s in r a t p u p s the
ontogenetic development of biological regulators crucially de-
p e n d s on ,the m o t h e r - i n f a n t unit, so in h u m a n development
psychological interpretive capacity evolves in t h e context of the
repetitive interactions with t h e m o t h e r .

5. In a series of s t u d i e s a t t h e Menninger Clinic we explored the

factor s t r u c t u r e of a n u m b e r of self-report m e a s u r e s of adult
a t t a c h m e n t . On b o t h c o m m u n i t y a n d clinical s a m p l e s we found
very similar r e s u l t s a c r o s s t h r e e investigations. In t h e first study
(Allen et al. 2000), two m e a s u r e s of a d u l t a t t a c h m e n t style—the
Relationship Q u e s t i o n n a i r e (Bartholomew a n d Horowitz .1991)
a n d t h e Adult A t t a c h m e n t Scale (Collins a n d Read 1990)—were
administered-to 2 5 3 individuals (99 female t r a u m a p a t i e n t s and
154 c o m m u n i t y controls). The factor s p a c e provided a reason-
able two-dimensional solution with a secure-fearful axis a n d a
dismissive-preoccupied axis. 2 We found t h e s a m e two factors—a
secure-fearful axis a n d a dismissive-preoccupied axis—in a rep-
lication s t u d y by Stein a n d colleagues, w h i c h u s e d five adult
a t t a c h m e n t - q u e s t i o n n a i r e m e a s u r e s , again on a mixed popula-
tion1; W h e n we plotted t h e subjects in t h e sample—both p a t i e n t s
a n d c o m m u n i t y controls—on t h e s a m e two principal compo-
n e n t s , it w a s clear t h a t while t h e secure-fearful axis w a s excel-
lent a t distinguishing t h e c o m m u n i t y s a m p l e from t h e patient
group, t h e dismissive-preoccupied axis did n o t distinguish the
g r o u p s well. W h a t w a s also clear w a s a s o m e w h a t unexpected
relationship between c o m p o n e n t scores. Although t h e overall
correlation between t h e two scales w a s negligible, a s you would
expect, t h e discrimination between dismissive a n d preoccupied
w a s s o m e w h a t greater toward t h e middle point of t h e s e c u r e -
fearful dimension.

2
In a principal-component analysis, a two-component solution accounted
for all eigen values greater than 1 and for 67.2% ofthe total variance.
 A Psychosocial Model of the Development of Mentalization / 135

One way of interpreting t h e s e d a t a is to a s s u m e t h a t security

represents a n experience of safety in closeness, w h e r e a s fearful-
ness relates to a disorganization of a t t a c h m e n t . T h e fearfulness
a p p e a r s to b e specific to a t t a c h m e n t relationships, a s n o n -
a t t a c h m e n t relationships rarely score highly on t h i s dimension.
The dismissing a t t a c h m e n t style a p p e a r s to offer protection to
the self by isolation, w h e r e a s in e n m e s h e d preoccupation self-
protection i s ' p e r h a p s afforded by a n amplification of t h e other,
by a denial or s u b j u g a t i o n o f t h e self.
We would a r g u e t h a t t h e safety-to-fearfulness d i m e n s i o n cor-
responds to t h e quality of functioning o f t h e IIM. At t h e high end,
the individual is well able to r e p r e s e n t complex internal s t a t e s of
the other a n d of t h e self. With a well-established higher-order
capacity for distinguishing psychological s t a t e s of t h e other a n d
the self, they n e e d n o additional strategies for conducting
productive i n t e r p e r s o n a l relationships. W h e n t h e psychological
m e c h a n i s m crucially u n d e r p i n n i n g a t t a c h m e n t is s o m e w h a t
weaker (as a function of a t t a c h m e n t history or biology), t h e
capacity for s u s t a i n i n g a clear distinction between self a n d other
also b e c o m e s weaker. In s u c h a s i t u a t i o n t h e individual will
require specific strategies to a c c o m m o d a t e to interpersonal en-
counters. The-two prototypical strategies a r e t h e avoidant a n d
resistant strategies.
But why a r e s u c h strategies n e c e s s a r y ? Both serve to protect
the self in t h e context of i n t e n s e i n t e r p e r s o n a l relations. We
a s s u m e t h a t t h e s e strategies m a y be n e c e s s a r y b e c a u s e t h e
self, which is, a s we h a v e seen, t h e p r o d u c t o f t h e other, always
remains vulnerable to social influence. To avoid s u c h instability,
against a b a c k g r o u n d of a relatively i n s e c u r e internal working
model, t h e individual c a n either deliberately w i t h d r a w a n d en-
hance t h e self-representation relative to t h e other r e p r e s e n t a -
tions (dismissing) or protectively overamplify a n d exaggerate t h e
other r e p r e s e n t a t i o n (preoccupied). In either case, t h e strategies
in representational t e r m s are a b o u t deliberately s e p a r a t i n g t h e
other from t h e self-representation.
Neither of t h e s e strategies is inherently pathological, al-
though b o t h signal a certain degree of w e a k n e s s . At t h e extreme
end of t h e safety-to-fearfulness dimension, t h e r e c a n be n o
 136 / Theoretical Perspectives

strategy b e c a u s e t h e a t t a c h m e n t s y s t e m is n o t t h e r e to s u s t a i n a
consistent set of defenses. In t h e s e c a s e s t h e interpretive mecha-
n i s m t h a t s u s t a i n s social relations functions so poorly t h a t the
capacity to arrive a t r e p r e s e n t a t i o n s of t h e motivational or epi-
stemic mind s t a t e s of t h e other, i n d e p e n d e n t of t h o s e of t h e self,
is profoundly compromised. This is a t t a c h m e n t disorganization
or, r a t h e r , t h e a b s e n c e of t h e m e n t a l function t h a t s u s t a i n s
a t t a c h m e n t . T h u s we conceive of a t t a c h m e n t disorganization as
lying a t t h e opposite e n d of t h e scale to a t t a c h m e n t security and
a s a n indicator of t h e regular failure of t h e interpersonal inter-
pretive m e c h a n i s m . As we a r g u e t h r o u g h o u t t h i s book, we con-
sider the quality of interpretive capacity to vary substantially
a c r o s s n o r m a l a n d clinical g r o u p s . At t h e low e n d of t h i s scale
are individuals w h o u s e a teleological r a t h e r t h a n a n intentional
s t a n c e in interpreting their own a n d others' behavior (see chap-
t e r s 5 a n d 8). As we shall see, t h e r e a s o n s for t h i s w e a k n e s s
might be linked to early s u b o p t i m a l e n v i r o n m e n t s t h a t could
create a vulnerability t h r o u g h u n d e r m i n i n g t h e r o b u s t n e s s of
t h e IIM (see particularly c h a p t e r 4) or t h e failure to appropriately
integrate developmentally early forms of r e p r e s e n t a t i o n s for sub-
jectivity (see c h a p t e r 6) d u e , for example, to a lack of playful
interactions with p a r e n t s or frank m a l t r e a t m e n t a t m u c h later
ages (see c h a p t e r s 10 a n d 11).
To s u m m a r i z e , we feel t h a t t h e r e a r e a t least five s t r a n d s of
converging evidence to suggest t h a t a key selective advantage
of a t t a c h m e n t might be t h e development of a n u n d e r s t a n d i n g of
internal states: (a) t h a t s e c u r e a t t a c h m e n t is associated with
favorable o u t c o m e s a c r o s s a wide r a n g e of relevant t a s k s ; (b) t h a t
s e c u r e a t t a c h m e n t predicts precocious performance in t a s k s
specifically calling for symbolic capacity; (c) t h a t t h e class of
early a t t a c h m e n t classification h a s less predictive weight t h a n
w h e t h e r a t t a c h m e n t experiences occurred; (d) t h a t a t t a c h m e n t
h a s b e e n d e m o n s t r a t e d to h a v e other ontogenetic biological func-
tions in m a m m a l i a n species t h a t have analogies or m a y parallel
t h e evolutionary function for a t t a c h m e n t proposed here; (e) t h a t
t h e factor s t r u c t u r e of a d u l t a t t a c h m e n t scales s e p a r a t e s out a
factor to do with type of a t t a c h m e n t (perhaps t h e i n t e r n a l work-
ing model) a n d t h e quality of a t t a c h m e n t (perhaps t h e interper-
sonal interpretive m e c h a n i s m ) .
 A Psychosocial Model of the Development of Mentalization / 137

THE NEURO-ANATOMICAL BASIS OF IIM-a AND IIM-c

So far we h a v e d i s c u s s e d t h e IIM a s if we t h o u g h t of it a s a
singular a n d u n i t a r y s y s t e m . In c h a p t e r 5 we p r e s e n t evidence
t h a t t h e acquisition of a n u n d e r s t a n d i n g of desires might a n t e -
date t h e acquisition of a capacity to u n d e r s t a n d epistemic s t a t e s
(such a s beliefs) by a s m u c h a s 18 m o n t h s . This discrepancy in
the developmental timetable s u g g e s t s t h a t s e p a r a t e m e c h a n i s m s
for interpersonal u n d e r s t a n d i n g concerning emotions a n d belief
states should b e considered. In t h i s section we p r e s e n t some
neuropsychological evidence t h a t p o i n t s in t h e s a m e direction.
We believe t h a t t h e IIM subdivides anatomically into two s u b -
s t r u c t u r e s : t h e IIM-a (a for affect) a n d t h e IIM-c (c for cognition).
Emotional r e s o n a n c e (empathy) m a y exemplify t h e former, while
reasoning a b o u t epistemic s t a t e s might b e prototypical of t h e
latter. T h e t e r m "theory of mind" or "mentalization" a s currently
used covers b o t h t h e s e aspects, a l t h o u g h t h e r e is a b i a s in t h e
literature toward e q u a t i n g mentalization with t h e u n d e r s t a n d i n g
of belief states.
The concept of e m p a t h y h a s b e e n variously defined. In t h i s
context t h e availability of a m e c h a n i s m t h a t allows one indi-
vidual to a s s u m e a n o t h e r ' s perspective a n d to infer a n d , to some
degree, experience their emotional s t a t e of m i n d is central. We
believe t h a t t h e psychological m e c h a n i s m t h a t we have labeled
the IIM-a is responsible for t h i s (Bleiberg, Fonagy, a n d Target
1997; Fonagy 2000). O t h e r w o r k e r s have independently come to
very similar theoretical conclusions (Blair 1995; Corcoran 2000).
Darwin considered s y m p a t h y to be t h e core moral emotion a s
it involved t h e a u t o m a t i c experiencing of t h e other's distress,
which gives rise to altruistic a t t e m p t s to offer comfort or relief
(O'Cormell 1998).
Neurophysiological s t u d i e s s u p p o r t t h e distinction. The p u r e -
ly cognitive t a s k of identifying belief s t a t e s in t h e other h a s b e e n
associated with activation of medial prefrontal foci a r o u n d BA8
using SPECT (single-photon emission c o m p u t e d tomography)
(Baron-Cohen et al. 1994), PET (Blair, J o n e s , Clark, a n d S m i t h
1997; Goel et al. 1995) a n d fMRI (Gallagher et al. 2000). The
infant's u n d e r s t a n d i n g of h i s own emotional r e s p o n s e s (by defi-
nition, a p r e c u r s o r of empathy) itself arises o u t of a complex
140 / Theoretical Perspectives

specific gene expression. Knowledge of t h e s e m e c h a n i s m s would

help u s s h a r p e n o u r intervention strategies a n d m a y p r o m p t u s
to advance n e w m o d e s of prevention or t r e a t m e n t intervention.
We would suggest t h a t a t least some psychosocial t r e a t m e n t s ,
like psychoanalysis, or preventive efforts, like affect training—for
example, t h e PATHS Program (Kusche a n d Greenberg 2001)—
work b e c a u s e they e n h a n c e t h e functioning of t h e IIM a n d
moderate gene expression. Of course, by e n h a n c i n g mentaliza-
tion, social a d a p t a t i o n in general might also be e n h a n c e d . In
either case, we m a i n t a i n t h a t a t t a c h m e n t - r e l a t e d early social
experiences of other m i n d s are n e c e s s a r y for t h i s to t a k e place
b e c a u s e t h e n o r m a l functioning of interpersonal interpretive
p r o c e s s e s r e q u i r e s s i m u l t a n e o u s a c c e s s to epistemic a n d affec-
tive information. Most probably, social experience in a n attach-
m e n t context in developmental periods of n e u r a l plasticity
e n h a n c e s connections between w h a t we a s s u m e to b e t h e a n a -
tomically s e p a r a t e b u t functionally normally integrated affective
a n d cognitive s t r u c t u r e s . This is why effective psychotherapy,
particularly with individuals w h o s e capacity for m e n t a l repre-
s e n t a t i o n s of i n t e r n a l s t a t e s is vulnerable, m u s t focus on affect
a s well a s cognition, be delivered in a n interpersonal context t h a t
permits t h e development of a t t a c h m e n t relationships, a n d meet
a criterion for coherence t h a t is consistent with t h e requirement
of repetition of stimuli in t h e generation of n e u r a l n e t w o r k s (e.g.,
R u m e l h a r t a n d McClelland 1986) a n d t h e switching-on of spe-
cific genes (Kandel 1998, 1999).
P e r h a p s , further into t h e future, we m a y envision t h e meas-
u r e m e n t of t h e o u t c o m e of psychosocial interventions by track-
ing c h a n g e s in t h e expression of specific g e n e s in specific sites
relevant for t h e development of psychopathology (the brain, en-
docrine organs, etc.). More realistically, suitability for specific
types of t r e a t m e n t m a y be determined in t e r m s of genetic vari-
ability. In t h e m e a n t i m e , we c a n m e a s u r e t h e i m p a c t of interven-
tions on m e a s u r e s t h a t might tap,into t h e IIM (the RF scale, the
"reading t h e m i n d in t h e eyes" test).
 A Psychosocial Model of the Development of Mentalization / 141

CONCLUSIONS

Though w h a t is proposed h e r e m a y s o u n d radical, w h e n closely

scrutinized it actually c o n t a i n s very little t h a t is new. We suggest
t h a t p s y c h o a n a l y s i s n e e d s to look to t h e cognitive n e u r o s c i e n c e s
to find its intellectual fulfillment. C u r r e n t theorization in n e u r o -
science is sadly devoid of c o n s i d e r a t i o n s of emotional life a n d
relationality even a r o u n d topics s u c h a s social development,
where t h e subject m a t t e r directly c o n c e r n s t h e child's subjectiv-
ity. Happily, t h e r e are a n u m b e r of energetic initiatives u n d e r -
way t h a t p u r s u e this p a t h for knowledge acquisition (e.g., Solms
1997a, 1997b), a n d a n e w j o u r n a l , Neuro-Psychoanalysis, offers
a ready forum for t h e s e developments.
The evidence clearly s h o w s t h a t it is naive to a s s u m e t h a t t h e
child's genotypic destiny is fulfilled in a hermetically sealed
brain, s o m e h o w isolated from t h e social environment within
which ontogeny o c c u r s a n d t h e s o u n d a d a p t a t i o n to w h i c h is t h e
organizing p u r p o s e of t h e whole system. Subjectivity, t h e u n d e r -
standing of t h e individual response, will be a n essential piece in
putting together t h e microbiological puzzle of genetic expression.
Psychoanalysis, with its focus on t h e r e p r e s e n t a t i o n of subjectiv-
ity a n d h o w t h i s emerges from early development, might have
m u c h to c o n t r i b u t e to t h e u n d e r s t a n d i n g of how individual dif-
ferences in t h e quality of functioning of basic m e n t a l m e c h a -
nisms arise. We a r e suggesting t h a t infant a t t a c h m e n t functions
—In p a r t a t least—to facilitate t h e development of a n interper-
sonal interpretive capacity. T h e quality of t h e early relationship
plays a major role in determining t h e r o b u s t n e s s of t h a t capacity,
b u t a t t a c h m e n t security per se is less relevant to later develop-
ment. T h e interpretive capacity, in t u r n , plays a key role in t h e
processing of social experience. T h e level of functioning of t h e IIM
will be reflected in a n individual's ability to function in close
interpersonal r e l a t i o n s h i p s w i t h o u t r e c o u r s e to strategies for
amplifying t h e distinction between self a n d other r e p r e s e n t a -
tions. The unfolding of d i s t u r b a n c e over time is conditioned by
the interpretive capacity—we s p e c u l a t e t h a t t h e expression of
pathogenic genotypes is m a d e m o r e likely by t h e poor function-
ing of a m e c h a n i s m designed to differentiate the psychological
states of self a n d other.
142 / Theoretical Perspectives

This is a function of i m m e n s e importance, a s t h e laborious

move from genotype t o p h e n o t y p e is conditioned in t h i s way. A
full u n d e r s t a n d i n g of t h e interaction between individual m e n t a l -
ized r e p r e s e n t a t i o n s of life experience a n d t h e expression of
genetic dispositions is t h e t a s k of t h e developmental p s y c h o p a -
thology of t h e next decades. Eric Kandel (1998)'cites Francois
J a c o b (1998), who wrote in Of Flies, Mice and Men: "The c e n t u r y
t h a t is ending h a s b e e n preoccupied with nucleic acids a n d
proteins. T h e next one will c o n c e n t r a t e on memory and desire.
Will it b e able to a n s w e r t h e q u e s t i o n s they pose?" (Jacob 1998,
p. 152).
PART I I

D E V E L O P M E N T A L P E R S P E C T I V E S

In Part II, we present a comprehensive picture of the development

of a psychological sense of self, beginning with infancy and
ending with adolescence. In chapter 4 we introduce the social
biofeedback view of mirroring, a precise account of the mecha-
nisms through which infants learn to identify and control affect
states through interaction with primary caregivers—moving from
coregulation to being self-regulating agents. The social biofeed-
back view of mirroring is a fundamental extension of psychoana-
lytic theory; it is important not just as an account of normal
development but as a basis for explaining later vulnerability to
psychosocial stress and psychopathology. (This is made evident
in the case material in chapter 7.) Chapter 5 moves on to delin-
eate five distinct aspects of the self: physical, social, teleological,
intentional, and representational—which is also autobiographi-
cal. The notion of the intentional stance—and its relation to the
teleological stance—borrowed from the philosophy of mind is
particularly important to our point of view, as it spells out how we
learn to fathom ourselves through fathoming others. We make the
case here for the central importance of intersubjectivity once it
urfolds in early development However, we criticize currently
popular arguments that intersubjectivity is present from the start
and argue instead that it emerges within the attachment relation-
ship together with the capacity for mentalization. Chapter 6
continues the developmental sequence: it highlights the dialectic
between "psychic equivalence" (that mental reality must map
onto physical reality) and "pretend" (that mental and physical
reality are completely separate from each other)—two modes of
childhood experience that become integrated through "playing
with reality," leading to the appreciation that the mind only par-
tially reflects external reality. Chapter 7 is a clinical illustration of
the usefulness of these concepts to the understanding of a young
boy whose disturbed relationship with his mother resulted in the
distortion of these developmental processes. Chapter 8 focuses
on the processes underpinning normal and pathological stresses
in adolescence and presents case material illustrating serious
psychopathology.
 The Social Biofeedback Theory
of Affect-Mirroring: T h e Development
of Emotional Self-Awareness
a n d Self-Control in Infancy

In m a n y w a y s t h i s c h a p t e r forms t h e core of o u r t h i n k i n g a b o u t
t h e role of affects in self-development—a theoretical a n d concep-
t u a l problem t h a t we tackle m o r e fully in c h a p t e r 5. We s t a r t t h i s
c h a p t e r by placing t h e c o n s t r u c t of emotions within t h e frame-
work of t h e development of intentionality a n d mentalization, t h e
c o n c e p t s t h a t lie a t t h e core of o u r theoretical a n d clinical work.
We t h e n focus on t h e n a t u r e of t h e developmental p r o c e s s e s
involved in t h e emergence of u n d e r s t a n d i n g of emotions in self
a n d other. T h e development of emotions d u r i n g t h e first year of
life is outlined a n d placed in t h e context of one of t h e organizing
concept^ of t h i s book: t h e infant's sensitivity to contingencies
b e t w e e n h i s a c t i o n s a n d their perceived environmental effects.
We describe t h e social biofeedback theory of emotional develop-
ment, w h i c h we see a s t h e key to u n d e r s t a n d i n g t h e link be-
tween early experience a n d later vulnerability to psychosocial
stress. We also point briefly to a n u m b e r of pathological m o d e s of
early infant-careglver interaction t h a t could give rise to later
psychological d i s t u r b a n c e a n d t h e vulnerability of t h e self a s
agent. C h a p t e r 5 t h e n a t t e m p t s to integrate t h e p a r t i c u l a r view
of emotional development described in this c h a p t e r within o u r
more general theoretical a p p r o a c h to t h e early development of
self a n d agency.

145
146 / Developmental Perspectives

EMOTIONAL DEVELOPMENT
FROM A THEORY-OF-MIND PERSPECTIVE

During t h e last decade philosophers (Dennett 1987; Fodor 1987,

1992) a n d cognitive developmentalists (Astington, Harris, a n d
Olson 1988; B a r o n - C o h e n et al. 1993; Hirschfeld a n d G e l m a n
1994; Perner 1991; Wellman 1990; Whiten 1991) h a v e focused
on t h e n a t u r e a n d developmental origins of o u r capacity to
attribute c a u s a l m e n t a l s t a t e s to others. D e n n e t t (1987) h a s
argued t h a t applying s u c h a mentalistic interpretational s t r a t -
egy, which he calls t h e "intentional stance," is a n evolutionary
a d a p t a t i o n t h a t is highly successful in predicting t h e behavior
of other agents. T h u s , t h e currently d o m i n a n t cognitive de-
velopmental view h o l d s t h a t even y o u n g children a r e so-called
belief-desire psychologists w h o a t t r i b u t e intentional m e n t a l
s t a t e s — s u c h a s goals, emotions, desires, a n d beliefs—to o t h e r s
a s t h e c a u s e s of their actions.
Researchers t a k e different views, however, w h e n t h e y a d d r e s s
t h e question of how children identify a n d a t t r i b u t e m i n d s t a t e s
to o t h e r s or to themselves. Simulation theorists (e.g., G o l d m a n
1993; P. L. Harris 1991, 1992) a s s u m e t h a t h u m a n s h a v e direct
introspective a c c e s s to their own m e n t a l s t a t e s , while t h e y have
to infer t h o s e of o t h e r s indirectly t h r o u g h imagining themselves
in their place a n d t h e n a t t r i b u t i n g t h e s i m u l a t e d m e n t a l experi-
ence to t h e other. In c o n t r a s t , o t h e r s (Dennett 1987; Gopnik
1993; Gopnik a n d Wellman 1994) a r g u e t h a t direct p e r c e p t u a l
access to m i n d s t a t e s is illusory, a n d they p r o p o s e t h a t t h e
identification of m e n t a l s t a t e s is equally inferential in t h e c a s e of
self a n d other.
W h e n do children t a k e t h e intentional s t a n c e a n d s t a r t to
infer m i n d s t a t e s In other a g e n t s ? While t h e a t t r i b u t i o n of a p p a r -
ently more complex intentional states, s u c h a s false beliefs,
generally a p p e a r only a t a r o u n d 3 - 4 y e a r s of age (see c h a p t e r 5
for a comprehensive developmental a c c o u n t of t h e emergence of
this ability—Perner 1991; Wellman 1990; W i m m e r a n d Perner
1983), m a n y (e.g., B r e t h e r t o h 1991a; S t e r n 1985; Tomasello
1999) believe t h a t certain n e w behaviors emerging d u r i n g t h e
last q u a r t e r of t h e first year, s u c h a s pointing a n d gaze alteration
(E. Bates .1979; B r e t h e r t o n a n d B a t e s 1979; M u r p h y a n d Messer
 Serial Biofeedback Theory of Affect-Mirroring / 147

1977) o r social referencing (Campos a n d S t e n b e r g 1981; Klin-

nert, Campos, Sorce, Emde, a n d Svejda 1983), imply t h e a p p e a r -
a n c e of a r u d i m e n t a r y ability on t h e infant's p a r t to a t t r i b u t e a t
least some k i n d s of m i n d s t a t e s — s u c h a s attention s t a t e s or
emotions—to other agents. In a series of h a b i t u a t i o n studies,
Gergely, Csibra, a n d their colleagues (Csibra, Gergely, Brock-
b a n k , Biro, a n d Koos 1999; Gergely et al. 1995) have provided
evidence t h a t 9- a n d 12-month-old infants can, indeed, interpret
a n agent's behavior a s goal-directed a n d rational a n d c a n predict
its future action toward t h e goal in a new situation on t h a t b a s i s .
However, 6 - m o n t h - o l d s showed n o signs yet of s u c h a n u n d e r -
s t a n d i n g of intentional behavior, w h i c h is in line with t h e gen-
eral a s s u m p t i o n t h a t t h e earliest time in development w h e n
infants m a y be able to t a k e t h e "intentional stance" toward other
a g e n t s is a r o u n d t h e e n d of t h e first y e a r (Tomasello 1995,
1999).
T h e "theory-of-mind" perspective is clearly relevant w h e n we
consider t h e origins of t h e infant's ability to u n d e r s t a n d a n d
a t t r i b u t e emotional s t a t e s to others. While m u c h of t h e discus-
sion in t h e theory-of-mind literature h a s c o n c e n t r a t e d on beliefs
a n d desires, it s h o u l d be clear t h a t emotions also belong to t h e
types of intentional m e n t a l s t a t e s t h a t we attribute to other
m i n d s to explain a n d predict their behavior. In fact, emotions
s h a r e m a n y of t h e r e p r e s e n t a t i o n a l properties t h a t characterize
intentional m e n t a l states. The "intentionality" of m e n t a l s t a t e s
s u c h a s beliefs a n d desires refers to their "aboutness" (Brentano
1874; D e n n e t t a n d H a u g e l a n d 1987)—thus, a belief is "about" a n
a c t u a l or possible s t a t e of affairs in t h e world, w h e r e a s a desire
is "about" a future s t a t e of affairs. Clearly, in t h a t s e n s e emo-
tions a r e also m e n t a l a t t i t u d e s t h a t are "about" some s t a t e of
affairs (as w h e n Peter is angry a b o u t having lost h i s wallet 1 ) a n d
attributing t h a t information to a p e r s o n c a n certainly help to
explain or predict h i s behavior.

1
That emotions belong to the class of Intentional mental states is also shown
by the fact that emotion terms, similarly to other "intentional idioms," express
propositional attitudes and are characterized by the semantic property of "refer-
ential opacity" (Dennett and Haugeland 1987; Quine 1960). This property refers
to the fact that certain logical operations, such as substitutability of terms with
 148 / Developmental Perspectives

However, w h e n a t t r i b u t i n g a n emotion to someone, o n e also

attributes dispositional information t h a t is related m o r e t o - t h e
attitude itself t h a n to t h e intentional object t h a t t h e a t t i t u d e is
about. Attributing "anger a b o u t having lost h i s wallet" to Peter
allows one to generate a set of predictions a b o u t h i s future
behavior t h a t a r e only incidentally related to w h a t h i s a n g e r is
about—for example, predicting t h a t Peter is likely to kick t h e dog
if h e s e e s it. T h e dispositional information t h a t e m o t i o n s e x p r e s s
specifies t h a t u n d e r certain c i r c u m s t a n c e s a p e r s o n w h o is in
the given dispositional emotion s t a t e is likely to b e h a v e in cer-
t a i n ways r a t h e r t h a n in others. In o t h e r words, it specifies a set
of potential s t a t e s of affairs t h a t c a n be propositionally described
in t e r m s of a set of "if-then" conditional s t a t e m e n t s . W h e n we
a t t r i b u t e a n emotion s t a t e to someone, we m u s t be able to
generate a t least some of t h e s e conditional s t a t e s of affairs in o u r
mind, otherwise we would n o t be able to infer a n y t h i n g a b o u t t h e
p e r s o n ' s future behavior. 2
Therefore, from a theory-of-mind perspective t h e central
questions of t h e psychology of emotional development would b e
t h e following: {a) How do infants come to k n o w a b o u t t h e dis-
positional c o n t e n t of emotions? (b) How do t h e y identify w h a t a n
emotion s t a t e is a b o u t ? (c) W h e n do they s t a r t to a t t r i b u t e either
k i n d s of information to other m i n d s to s u p p o r t r e a s o n i n g a b o u t
behavior? (d) How do they learn t h e conditions u n d e r w h i c h t h e
attribution of emotions to others—or, for t h a t m a t t e r , to t h e m -
selves—is justified?
In t h e latter regard, we s h o u l d n o t e t h a t emotions differ in
interesting ways from other intentional m e n t a l s t a t e s s u c h a s
beliefs a n d desires. First, emotions m a y be easier to infer in
a n o t h e r person, b e c a u s e t h e y tend to be a c c o m p a n i e d by sali-

identical referents, break down in the case of expressions involving intentional

relations such as "x believes that p" or "y desires that q." Thus, while the
statement "Oedipus was angry about Laius's comments" is true, it does not
follow that "Oedipus was angry about his father's comments" is also true, even
though "Laius" and "Oedipus's father" refer to the same individual.
2
In fact, apart from their dispositional content, we often exploit other types of
knowledge as well when we reason about emotions—for example, knowledge
about the typical causes of emotions or about the typical consequences of acting
emotionally (Watson 1995).
 Social Biofeedback Theory of Affect-Mirroring / 149

e n t — a n d , in t h e case of b a s i c emotions, possibly universal—

expressive facial displays (Ekman 1992; E k m a n , Friesen, a n d
Ellsworth 1972; Izard 1977). Also, having a n emotion s e e m s to
involve specific a n d differential c h a n g e s in physiological a r o u s a l
(at least, in t h e c a s e of some b a s i c emotions—see E k m a n , Leven-
son, a n d Friesen 1983), a s well a s a characteristic subjective
feeling state, which, it c a n be a r g u e d , m a k e s correct self-attribu-
tion relatively easy. F u r t h e r m o r e , t h e r e is evidence suggesting
t h a t t h e r e m a y be a set of b a s i c emotions t h a t is universal a n d
i n n a t e ( E k m a n 1992; E k m a n et al. 1972; Izard 1977, 1978). O n
t h e b a s i s of t h e s e c o n s i d e r a t i o n s it s e e m s plausible to a s k
w h e t h e r emotions a r e among—if n o t the—earliest m e n t a l s t a t e s
t h a t infants a t t r i b u t e to m i n d s (cf. Meltzoff a n d Gopnik 1993),

IMITATION-BASED ATTRIBUTION OF EMOTIONAL

STATES: T H E MELTZOFF-GOPNIK HYPOTHESIS

Meltzoff a n d Gopnik (1993) proposed t h a t i n n a t e m e c h a n i s m s

allow t h e infant to a t t r i b u t e emotional s t a t e s to o t h e r s from t h e
beginning of life. Their theory is b a s e d on Meltzoff s extended
work (Meltzoff a n d Moore 1977, 1989) d e m o n s t r a t i n g a n i n n a t e
ability a n d inclination in n e w b o r n b a b i e s to imitate certain facial
g e s t u r e s of a d u l t s — s u c h a s t o n g u e p r o t r u s i o n a n d m o u t h open-
ing—and m a y b e also t h e c o m p o n e n t s of some of t h e basic
facial emotion expressions (Field, Woodson, Cohen, Garcia, a n d
Greenberg 1983). Additionally, their model a s s u m e s t h e exist-
ence of a n i n n a t e set of p r i m a r y emotions t h a t a r e expressed by
prewired facial m u s c u l a r action p a t t e r n s (Ekman 1992b; E k m a n
e t a l . 1972; Izard 1977, 1978).
Based on E k m a n et al.'s (1983} findings with a d u l t s , Meltzoff
a n d Gopnik suggest t h a t t h e r e a r e prewired bidirectional con-
nections between facial emotion expressions a n d corresponding
differential physiological emotion s t a t e s , w h i c h are active from
birth. T h u s , they e m b r a c e a basic a s s u m p t i o n of differential
emotions theory (Izard 1977; Izard a n d Malatesta 1987; Mala^
t e s t a a n d Izard 1984), according to w h i c h "there is a n i n n a t e
expression-to-feeling c o n c o r d a n c e in t h e y o u n g infant" (Mala-
 150 / Developmental Perspectives

testa et al. 1989, p. 6). They hypothesize t h a t w h e n t h e infant

imitates the adult's facial emotion expression, h e automatically
activates, t h r o u g h t h e s e prewired connections, t h e correspond-
ing bodily emotion s t a t e in himself. In their words, "imitation of
behavior provides t h e bridge t h a t allows t h e i n t e r n a l m e n t a l
state of a n o t h e r to 'cross over' to a n d become one's own experi-
enced m e n t a l state" (Meltzoff a n d Gopnik 1993, p. 358). Accord-
ing to Meltzoff a n d Gopnik, t h e imitation-generated emotion
state is t h e n introspectively accessed, a n d t h e felt affect is attrib-
uted to t h e other's m i n d .
However, t h e r e is n o direct evidence to s u p p o r t t h e a s s u m p -
tion t h a t discrete i n n a t e emotion displays automatically activate
emotion-specific c o n s c i o u s feeling s t a t e s in early infancy. In fact,
several r e s e a r c h e r s explicitly reject t h i s possibility, a r g u i n g t h a t
affect s t a t e s a r e likely to b e undifferentiated d u r i n g t h e first few
m o n t h s of life a n d t h a t t h e a p p e a r a n c e of differentiated con-
scious feeling s t a t e s is t h e c o n s e q u e n c e of cognitive development
(e.g., Sroufe 1979). Lewis a n d Michaelsoh (1983) a r g u e t h a t ,
d u r i n g t h e earliest p h a s e s of infancy, internal s t a t e s a n d expres-
sive behaviors a r e n o t yet coordinated a n d t h a t c o n s c i o u s feeling
s t a t e s t h a t are linked to discrete expressive displays emerge only
later d u e to t h e influence of socialization a n d cognitive growth
(see also Kagan 1992; Lewis a n d Brooks 1978).
In addition to e m b r a c i n g t h e — a s yet u n s u p p o r t e d — i n n a t i s t
a s s u m p t i o n of a n initial linkage between emotion expressions
a n d specific feeling states, t h e Meltzoff-Gopnik model m u s t m a k e
a further nativist a s s u m p t i o n to a c c o u n t for t h e e n s u i n g a t t r i b u -
tion of t h e imitation-generated emotion s t a t e to t h e other's m i n d .
Without that, t h e proposed imitation-mediated emotional conta-
gion p r o c e s s would g e n e r a t e a n emotion s t a t e in t h e infant t h a t
would m a t c h t h e adult's expressed affect, b u t t h e p r o c e s s would
stop there, a n d n o m e n t a l - s t a t e a t t r i b u t i o n would occur. Accord-
ingly, Meltzoff a n d Gopnik go on to a r g u e t h a t "one f u n d a m e n t a l
a s s u m p t i o n of m e n t a l i s m — t h a t external, visible behaviors a r e
m a p p e d onto phenomenologically m e n t a l states—is a p p a r e n t l y
given innately" (1993, p. 340). This a s s u m p t i o n of "primary
intersubjectivity" is extensively scrutinized in c h a p t e r 5.
But even if one were to accept t h e i n n a t i s t set of a s s u m p t i o n s
of the Meltzoff-Gopnik model; t h e r e would still r e m a i n a ques-
 Social Biofeedback Theory of Affect-Mirroring / 151

tion c o n c e r n i n g t h e n a t u r e of t h e imitation-generated affect s t a t e

t h a t s e e m s crucial from t h e point of view of t h e theory-of-mind
a p p r o a c h to emotional development. Apart from experiencing a
differential phenomenological quality, is it proposed t h a t t h e
b a b y b e c o m e s a w a r e of t h e dispositional c o n t e n t of t h e emotion
s t a t e a s well—not to m e n t i o n its a b o u t n e s s ? It is n o t clear
w h e t h e r Meltzoff a n d Gopnik (1993) conceive of t h e dispositional
c o n t e n t of emotions a s also genetically specified, b u t it is clear
that without making that strong innatist assumption, attribut-
ing pure—uninterpreted—physiological feeling s t a t e s to t h e
other would n o t serve t h e vital evolutionary function of t h e
"intentional stance": it would n o t help t h e infant in predicting t h e
o t h e r ' s behavior.
Finally, a central a s s u m p t i o n of t h e Meltzoff-Gopnik model is
t h e proposition t h a t from t h e beginning of life infants h a v e direct
introspective a c c e s s to their i n t e r n a l emotion states. However,
t h e viability of t h e classical C a r t e s i a n position, according to
w h i c h t h e m e n t a l s t a t e s of t h e self a r e accessed directly t h r o u g h
(infallible) introspection while t h o s e of t h e other h a v e to be
inferred on t h e b a s i s of indirect evidence, h a s b e e n a m a t t e r of
lively d e b a t e in t h e theory-of-mind literature. (See c h a p t e r 5 for a
detailed criticism of t h i s C a r t e s i a n a s s u m p t i o n . ) In fact, Gopnik
(1993) herself a r g u e d forcefully t h a t in development, u n d e r -
s t a n d i n g of m i n d s t a t e s in t h e other a n d in t h e self a p p e a r s
s i m u l t a n e o u s l y a n d is b a s e d on-similar inferential p r o c e s s e s in
b o t h c a s e s . (See also D e n n e t t 1987, c h a p t e r 4.) In contrast, for
t h e c a s e of emotions, t h e Meltzoff-Gopnik (1993) model implies
innately given direct introspective a c c e s s to t h e affective s t a t e s of
t h e self. Below we argue, however, t h a t emotions should n o t be
considered a special c a s e in t h i s respect. We propose a n alterna-
tive view, according to w h i c h t h e infant in h i s initial s t a t e is n o t
yet sensitive to t h e g r o u p s of i n t e r n a l - s t a t e c u e s t h a t a r e indica-
tive of discrete emotion categories.
In s u m , it s e e m s t h a t t h e Meltzoff-Gopnik model, while intel-
lectually intriguing a n d b a s e d on s o m e i m p o r t a n t insights, is
heavily b u r d e n e d with i n n a t i s t a s s u m p t i o n s , some of which, we
believe, m i g h t be avoided in a c c o u n t i n g for t h e developmental
lines leading to t h e u n d e r s t a n d i n g a n d attribution of emotions in
infancy. In w h a t follows, we outline a n alternative a p p r o a c h to
 152 / Developmental Perspectives

conceptualizing early emotional development, which, while per-

h a p s more p a r s i m o n i o u s , is, admittedly, equally speculative.

INITIAL SENSITIVITY
TO INTERNAL V E R S U S EXTERNAL STIMULI

We believe t h a t t h e r e is n o compelling r e a s o n to a s s u m e t h a t t h e
dispositional c o n t e n t s of emotion s t a t e s a r e available to t h e
infant a t birth. This is, of course, n o t to deny t h e potential
presence of i n n a t e p r i m a r y emotions, which c a n be conceptual-
ized a s complex prewired behavioral organizations activated u n -
der specific i n p u t conditions. S u c h emotion p r o g r a m s a r e likely
to contain information a b o u t t h e goal—such a s removal of obsta-
cle—and: t h e specific action tendencies—for example, a p p r o a c h
a n d attack—characteristic of t h e given emotion (anger), w h i c h
could b e u s e d to s u p p o r t a t least s o m e predictions a b o u t likely
actions. However, we a s s u m e t h a t t h i s information is repre-
sented in a n implicit form a s p r o c e d u r a l knowledge, a n d a s s u c h
it is at first cognitively inaccessible to.the infant.
Instead, we propose t h a t t h e dispositional c o n t e n t of emotions
is learned first b y observing t h e affect-expressive displays of
o t h e r s a n d associating t h e m with t h e s i t u a t i o n s a n d behavioral
o u t c o m e s t h a t a c c o m p a n y t h e s e emotion expressions. Of course,
if Meltzoff a n d Gopnik a r e right in a s s u m i n g t h a t t h e infant h a s
direct introspective a c c e s s to h i s i n n a t e p r i m a r y emotion s t a t e s ,
s u c h p e r c e p t u a l learning could be b a s e d on monitoring t h e
emotional s t a t e s of t h e self a s well a s t h o s e of others.
In a s s u m i n g t h a t t h e infant's initial s t a t e is characterized by
direct introspective a c c e s s to i n t e r n a l s t a t e s , Meltzoff a n d Gop7
nik (1993) follow t h e tradition of a long line of developmental
theorists. For example, F r e u d a n d o t h e r p s y c h o a n a l y s t s (e.g.,
Mahler et al. 1975) h a v e long held t h e view t h a t t h e infant
is initially more sensitive to internal t h a n to external stimuli.
Bruner, Olver, a n d Greenfield (1966) also proposed t h a t t h e
infant moves from a n initial reliance on internal, proprioceptive
c u e s to a reliance on exteroceptive c u e s (see also Birch a n d Lef-
ford 1967; Gholson 1980; for a review, see Rovee-Collier 1987).
 Social Biofeedback Theory of Affect-Mirroring / 153

However, a s Colombo, Mitchell, Coldren, a n d Atwater (1990)

h a v e pointed out, t h e r e a r e practically n o empirical d a t a in t h e
infant learning literature to s u p p o r t t h i s classical a s s u m p t i o n
directly. In c o n t r a s t , in a series of experiments designed to
t e s t t h e a s s u m p t i o n , t h e s e a u t h o r s have d e m o n s t r a t e d t h a t
3 - m o n t h - o l d s s h o w discrimination learning on t h e b a s i s of exte-
roceptive a s well a s interoceptive c u e s . 3 Moreover, in 6- a n d
9 - m o n t h - o l d s t h e y actually found d o m i n a n c e of t h e exterocep-
tive over t h e interoceptive c u e s in learning.
Therefore, it s e e m s to u s t h a t it might be worthwhile to
explore t h e c o n s e q u e n c e s of a b a n d o n i n g t h e classical a s s u m p -
tion concerning t h e p r e s u m e d d o m i n a n c e of internal stimuli in
t h e initial s t a t e of t h e infant. In fact, we hypothesize t h a t a t t h e
beginning of life the perceptual system is set with a bias to attend
to and explore the external world and builds representations pri-
marily on the basis of exteroceptive stimuli. In t h i s view, t h e n , t h e
set of internal—visceral a s well a s proprioceptive—cues t h a t a r e
activated w h e n being in a n d expressing a n emotion state are, a t
first, n o t perceived consciously by t h e infant, or, a t least, a r e n o t
grouped together categorically in s u c h a m a n n e r t h a t they could
be perceptually a c c e s s e d a s a distinctive emotion state. 4
This r a i s e s t h e question; How, on t h e b a s i s of this theory,
does t h e infant develop a w a r e n e s s of a n d conie to r e p r e s e n t t h e
s e t s of i n t e r n a l - s t a t e c u e s a s indicating categorically distinct

3
Note furthermore that'one cannot rule out the possibility that the position
cues in Colombo et al.'s (1990) study, which were based on eye fixation, might
have been computed on the basis of the position of the nose, which is, in fact, an
exteroceptive cue, see Bower (1974).
4
As will become apparent, our proposal does not necessarily imply—while
being compatible with—the more radical view that at the beginning of life infants
are lacking any kind of awareness of their internal states. It is possible that the
infant has some awareness of the component stimuli that belong to the groups of
internal-state cues that are indicative of categorical emotions, but only as part of
the "blooming, buzzing confusion" (W. James, 1890) of internal sense impres-
sions he may experience. Such state cues may also contribute to the overall—
positive or negative—hedonic quality of the infant's awareness. Our—less
radical—suggestion is (a) that the groups of internal-state cues that are indica-
tive of dispositional emotion states are initially not perceptually accessible as
distinct feeling states, and (b) that the infant's perceptual system is at the start
set with a bias to actively explore and categorize external rather than internal
stimuli.
154 / Developmental Perspectives

emotion s t a t e s ? We propose t h a t t h e species-specific h u m a n

propensity for t h e facial a n d vocal reflection of t h e infant's
emotion-expressive displays d u r i n g affect-regulative interactions
plays a crucial role in this developmental process. Below we
identify a n u m b e r of significant developmental c o n s e q u e n c e s of
t h e instinctive h u m a n inclination to expose infants to affect-
reflective behavioral displays d u r i n g emotion-regulative interac-
tions. We also a r g u e t h a t all of t h e s e c o n s e q u e n c e s a r e mediated
by t h e s a m e underlying m e c h a n i s m — n a m e l y , contingency de-
tection a n d maximizing. Before describing o u r model, however,
let u s briefly review t h e available empirical evidence on t h e role
a n d n a t u r e of affect-regulative interactions d u r i n g emotional
development in t h e first year of life.

EMOTIONAL DEVELOPMENT
DURING T H E F I R S T YEAR OF LIFE

During t h e last thirty y e a r s we h a v e w i t n e s s e d t h e a c c u m u l a t i o n

of a large body of compelling evidence in developmental psychol-
ogy t h a t h a s radically c h a n g e d o u r conceptualization of t h e
initial state of t h e infant. While n o t so long ago t h e s t a n d a r d view
held t h a t a t t h e beginning of life infants a r e basically passive,
undifferentiated, diffuse o r g a n i s m s s u r r o u n d e d by a s t i m u l u s
barrier (e.g., Mahler et al. 1975), it is now generally accepted
t h a t they are equipped from t h e s t a r t with r e m a r k a b l y rich
perceptual, learning, a n d r e p r e s e n t a t i o n a l capacities a n d spe-
cific p r e p a r e d n e s s for t h e s t r u c t u r e of t h e physical a n d social
world a r o u n d t h e m (Bower 1974; E m d e 1988; Gergely 1992;
Meltzoff 1990; S t e r n 1985). \
This c h a n g e of perspective h a s certainly also characterized
recent r e s e a r c h on early emotional development ( E k m a n 1992a;
E k m a n a n d Oster 1979; Izard 1977; Izard a n d Malatesta 1987;
Malatesta et al. 1989; Tronick a n d C o h n 1989), w h i c h a s s u m e s a
strong biosocial p r e p a r e d n e s s for emotion expression a n d emo-
tional c o m m u n i c a t i o n in infancy. Following Darwin's (1872)
early insight, recent c r o s s - c u l t u r a l r e s e a r c h o n facial emotion
expressions (Ekman 1992b; E k m a n et al. 1972; Izard 1977,
 Social Biofeedback Theory of Affect-Mirroring / 155

1978) h a s indicated t h a t t h e r e is a set of i n n a t e basic emotions—

including, a t least, enjoyment, anger, fear, s a d n e s s , disgust, a n d
s u r p r i s e — t h a t are expressed by t h e s a m e facial m u s c u l a r action
p a t t e r n s a c r o s s c u l t u r e s a n d a r e universally recognized. Young
infants h a v e b e e n reported to m a k e nearly all t h e m u s c l e move-
m e n t s t h a t a r e u s e d by a d u l t s to e x p r e s s t h e primary emotions
( E k m a n a n d Oster 1979; Oster 1978), a n d t h e facial expressions
of interest, joy, disgust, surprise, a n d d i s t r e s s have b e e n identi-
fied in y o u n g b a b i e s (Izard 1978). Furthermore, t h e facial m u s -
c u l a r a c t i o n s involved in t h e expression of a t least some of t h e
universal emotions have b e e n s h o w n in a d u l t s to generate spe-
cific a n d differential physiological a r o u s a l p a t t e r n s characteris-
tic of t h e given emotion (Ekman et al. 1983).
Based on findings s u c h a s these, n u m e r o u s psychologists
e m b r a c e d t h e view t h a t basic emotions a r e i n n a t e dynamic
behavioral organizations with adaptive functions, characterized
by specific facial display p a t t e r n s t h a t a r e connected t h r o u g h
prewired activation c h a n n e l s to differential physiological re-
s p o n s e s t r u c t u r e s ( E k m a n 1992b; E k m a n a n d Oster 1979; Izard
1977, 1978; Izard a n d M a l a t e s t a 1987; Malatesta et al. 1989;
Meltzoff a n d Gopnik 1993).
F u r t h e r m o r e , t h e c u r r e n t l y d o m i n a n t biosocial view of emo-
tional development holds t h a t m o t h e r a n d infant form a n affec-
tive c o m m u n i c a t i o n s y s t e m from t h e beginning of life (Beebe,
Jaffe, a n d L a c h m a n n 1992; Bowlby 1969; Brazelton, Kowslow-
ski, a n d Main 1974; Hobson 1993; S a n d e r 1970; S t e r n 1977,
1985; T r e v a r t h e n 1979; Tronick a n d C o h n 1989) in w h i c h t h e
m o t h e r plays a vital interactive role in m o d u l a t i n g t h e infant's
affective s t a t e s . While y o u n g infants do have some r u d i m e n t a r y
m e a n s of affective self-regulation—such a s t u r n i n g away from
overarousing stimuli or t h u m b - s u c k i n g (Demos 1986; Malatesta
et al. 1989)—there is a g r e e m e n t t h a t t h e quality of m a t e r n a l
interactions exerts a s t r o n g regulative influence on t h e infant's
affective s t a t e c h a n g e s (Field 1994; Malatesta a n d Izard 1984,
1989; Tronick, Ricks, a n d C o h n 1982). Mothers a r e generally
r a t h e r efficient in r e a d i n g their infants' emotion displays, a n d
sensitive m o t h e r s t e n d to a t t u n e their own affective r e s p o n s e s to
m o d u l a t e their infants' emotional s t a t e s (Malatesta et al. 1989;
Tronick a n d C o h n 1989). There is also some evidence t h a t in-