Affect Regulation Theory: A Clinical Model

by Daniel Hill, Allan N. Schore Ph.D. (Foreword by)

Overview

The rich, complex theory of affect regulation boiled down into a clinically useful guide.

Affect regulation theory—the science of how humans regulate their emotions—is at the root of all psychotherapies. Drawing on attachment, developmental trauma, implicit processes, and neurobiology, major theorists from Allan Schore to Daniel Stern have argued how and why regulated affect is key to our optimal functioning. This book translates the intricacies of the theory into a cogent clinical synthesis.

With clarity and practicality, Hill decodes the massive body of contemporary research on affect regulation, offering a comprehensible and ready-to-implement model for conducting affect regulation therapy.

The book is organized around the four domains of a clinical model: (1) a theory of bodymind; (2) a theory of optimal development of affect regulation in secure attachment relationships; (3) a theory of pathogenesis, in which disordered affect regulation originates in relational trauma and insecure attachment relationships; and (4) a theory of therapeutic actions targeted to repair the affect regulating systems.

The key themes of Hill’s affect-focused approach include: how and why different patterns of affect regulation develop; how regulatory patterns are transmitted from caretakers to the infants; what adaptive and maladaptive regulatory patterns look like neurobiologically, psychologically, and relationally; how deficits in affect regulation manifest as psychiatric symptoms and personality disorders; and ultimately, the means by which regulatory deficits can be repaired. Specific chapters explore such subjects as self states, mentalization, classical and modern attachment theory, relational trauma (and its manifestations in chronic dissociation, personality disorders, and pervasive dissociated shame), supporting self-development in therapy, patient–therapist attunement, implicit and explicit therapeutic actions, and many more.

Product Details

ISBN-13:	9780393707267
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	08/31/2015
Series:	Norton Series on Interpersonal Neurobiology
Edition description:	New Edition
Pages:	320
Sales rank:	865,673
Product dimensions:	5.70(w) x 8.40(h) x 1.30(d)

About the Author

Daniel Hill, PhD, is a psychoanalyst, educator and a leading proponent of the affect regulation model. His publications and presentations include topics ranging from the clinical use of multiple models to religious fundamentalism. The founder/director of PsyBC (1996-2014), he is currently the Editor-in-Chief of CSAR.NYC (the Center for the Study of Affect Regulation. CSAR.NYC conducts yearly conferences and workshops. Privately, Dr. Hill conducts on-going study groups focused on an in depth understanding of the regulation of affect. He is in private practice in NYC where he is on the faculties of the National Institute of the Psychotherapies and the New York University Postdoctoral Program in Psychoanalysis and Psychotherapy. Dr. Hill can be contacted at [e-mail].

Allan N. Schore, PhD, is on the clinical faculty of the Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, and at the UCLA Center for Culture, Brain, and Development. He is the recipient of the American Psychological Association Division 56: Trauma Psychology "Award for Outstanding Contributions to Practice in Trauma Psychology" and APA's Division 39: Psychoanalysis "Scientific Award in Recognition of Outstanding Contributions to Research, Theory and Practice of Neuroscience and Psychoanalysis."He is also an honorary member of the American Psychoanalytic Association. He is author of three seminal volumes, Affect Regulation and the Origin of the Self, Affect Dysregulation and Disorders of the Self and Affect Regulation and the Repair of the Self, as well as numerous articles and chapters. His Regulation Theory, grounded in developmental neuroscience and developmental psychoanalysis, focuses on the origin, psychopathogenesis, and psychotherapeutic treatment of the early forming subjective implicit self. His contributions appear in multiple disciplines, including developmental neuroscience, psychiatry, psychoanalysis, developmental psychology, attachment theory, trauma studies, behavioral biology, clinical psychology, and clinical social work. His groundbreaking integration of neuroscience with attachment theory has lead to his description as "the American Bowlby" and with psychoanalysis as "the world's leading expert in neuropsychoanalysis." His books have been translated into several languages, including Italian, French, German, and Turkish.

Table of Contents

Preface and Acknowledgments ix

Foreword Allan N. Schore xiii

Introduction Affect and Its Regulation 1

Part 1 Theory of Bod/mind: Regulated-Integrated Versus Dysregulated-Dissociated 13

Chapter 1 Affect Regulation and the Attachment Relationship 15

Chapter 2 Self-States: Regulated-Integrated Versus Dysregulated-Dissociated 27

Chapter 3 The Neurobiology of the Primary Affect-Regulating System 49

Chapter 4 The Right Brain, Implicit Processes, and the Implicit Self 68

Part 2 Theory of Development: Secure Attachment and the Development of Affect Regulation 83

Chapter 5 Classical Attachment Theory 85

Chapter 6 Mentalization: The Secondary Affect-Regulating System 98

Chapter 7 Modern Attachment Theory: The Development of the Primary Affect-Regulating System 112

Part III Theory of Pathogenesis: Relational Traumas and Their Sequelae 133

Chapter 8 Relational Traumas: Developmental Origins of Disordered Affect Regulation 135

Chapter 9 Chronic Dissociation: A Sequela of Relational Trauma 154

Chapter 10 Personality Disorders: A Second Sequela of Relational Trauma 168

Chapter 11 Pervasive Dissociated Shame: A Third Sequela of Relational Trauma 183

Part IV Theory of Therapeutic Actions: Therapeutic Processes and the Emergence of the Self 193

Chapter 12 Therapeutic Aims: Restoration of Self-Development 195

Chapter 13 Therapeutic Actions: Explicit and Implicit 206

Chapter 14 Interactive Regulation and Vitalizing Attunement 219

Bibliography 237

Index 257

Editorial Reviews

"With Affect Regulation Theory, Daniel Hill makes an invaluable contribution to the growing field of psychotherapy that is reflective of a psychobiological perspective. The book is well written, well researched, and comprehensive. For any therapist seeking to broaden his or her theoretical knowledge base, with the ultimate goal of incorporating that information into clinical practice, I recommend reading this book first and foremost."

Stan Tatkin

"Understanding affect is central to human psychology. From the start, Freud was concerned with the vicissitude of how emotions connected to ideas and to their transformations into symptoms and psychopathology. And yet psychoanalysis has been slow to develop a comprehensive theory of affects. Daniel Hill is a master teacher, and in Affect Regulation Theory he demonstrates how affects and their regulation and dysregulation are central to our sense of agency, authenticity, and interpersonal relations. He grounds his understanding in psychoanalysis, attachment theory, and neurobiology and illuminates the clinical relevance of relational trauma, dissociation, and self-states, thus integrating a comprehensive theory of mind, development, psychopathology, and psychotherapy. This book is essential reading for graduate students and clinicians."

Lewis Aron

"Affect regulation theory is the surprising meeting ground of neurobiology, developmental psychology, and psychoanalysis. In this important book, Daniel Hill captures its relevance to each of these realms. His book not only enhances our understanding of the physiological basis of emotions but also illuminates how emotional trauma in childhood emerges from prolonged states of dysregulation. Wonderfully comprehensive and engagingly written, this book will be a book to students. But it will also captivate those of us whose education preceded these exciting cross-disciplinary developments."

Robert B. Karen

"Daniel Hill has written a beautiful, user-friendly translation and elaboration of the theories of Allan Schore, Daniel Siegel, and Peter Fonagy. Illustrating with clinical vignettes, Hill integrates affect regulation, early attachment trauma, and theories of neurobiology. This is an excellent book for the working clinician."

Beatrice Beebe