Affective association: an effective intervention in countering fragmentation and dissociation

Abstract

This paper is concerned with the processes, both psychoanalytic and neuroscientific, involved in the undoing of dissociation in a 3-year-old, who was seen weekly over a nine month period. A neuroscientific and psychoanalytic developmental framework is used to follow a sequence of phenomena that emerged over the duration of relatively brief once weekly psychotherapy. Splintered aspects of the personality are shown to co-exist using different but related primitive defences, namely: dissociation, projective identification and somatic tremor. Clinical material of this traumatised child is used to illustrate the struggle to regulate changing affective states and their manifestations and to suggest a developmental progression occurring during the psychotherapy. Speculatively it is suggested that whilst mirror neurons would have been present from birth, the process of dissociation inhibited their functioning. One of the outcomes of therapy was to recruit mirror neurons in the service of developing processes of identification and empathy. Only then could a transference relationship begin.

Keywords:

• Affect attunement
• dissociation
• mentalisation
• mirror neurons
• neuroscience
• projective identification
• tremor

Notes

1. Mirror neurons are specialised networks of neurons found in the brain, which fire both during an action and when observing the same action performed by another – as if the observer was himself acting. It is speculated that mirror neurons are involved in: 1) learning new skills through imitation, 2) understanding the action and intentions of others, 3) empathy, 4) the acquisition of language and 5) the development of theory of mind (Cozolino, 2006).

2. Myelin is a fatty (phospholipid) electrically insulating sheath that covers the axons of many neurons. A myelinated fibre is able to transmit impulses at greater speed than an unmyelinated fibre. Therefore, the degree of myelination has implications for brain function.

3. The corpus callosum is a thick band consisting of millions of nerve fibres (axons of cells in the cerebral cortex) that orient themselves to link left and right hemispheres of the brain.