The Impact of Attachment: Developmental Neuroaffective Psychology

Combining Theories of neurobiology, attachment, interpersonal relationships, and intrapsychic concepts, The Impact of Attachement brings modern developmental psychology into dialogue with recent developments in neuroscience, describing a new, integrative approach to working with clients: developmental neuroaffective psychology.

Hart explains how the dichotomies of brain/mind, biology/experience, and nature/nurture hamper the development of a theory that is capable of fully embracing the complexity that characterizes human psychological development. An interactive, neurobiological, and interpersonal perspective, she argues, will help develop a common basis for helping clients in theraphy. Each chapter demonstrates and explores key aspects of the importance of attachment, and throughout, Hart reviews case stories from her own clinical practice, drawing from years of conducting psychological assessments of children, family interventions, individual therapy, and professional supervision assignments.

As Hart explains at the outset, our brains are sculpted, neuron by neuron, in a close interaction between genetic conditions and environmental stimulation, and thanks to their tremendous plasticity, they are capable of reorganization. In Part I, she looks at children's normal development, brain maturation within the close caregiverinfant relationship, and the development of the various levels of mental organization in infants. She emphasizes the importance of interaction with the primary caregiver for the child's neuroaffective development, including the formation of internal representations and mentalization capacity, and presents a model for levels of mental organization, or developmental stages when the nervous system undergoes qualitative changes with regard to personality development.

Part II looks at attachment and relational disorders---including dysregulation patterns and misattuned communication---and offers a new preliminary understanding of psychopathology based on a neuroaffective and developmental perspective. Part III aims to integrate existing therapeutic approaches within a neuroaffective framework. Hart calls for a higher degree of precision in the methods of intervention related to symptom formation and therapy aimed at children and adolescents. She summarizes considerations concerning emotional attunement and its impact on the therapist-client relationship, and discusses a complex approach to therapeutic intervention based on a neuroaffective model. The book concludes with a look into intervention in a broader context, integrating the treatment interventions into a dynamic system with both family and environmental therapy.

Part of the Norton Series on Interpersonal Neurobiology, The Impact of Attachment transforms complex neurobiological and behavioral theory into protocols that can be easily implemented by the practicing clinician.

Susan Hart is a psychologist in private practice and works mainly with professional supervision of psychologists, visiting nurses, social workers in child and family departments, personnel in child psychiatric wards, and advisors to foster families. She is the author of several books and articles on developmental neuroaffective psychology and frequently gives lectures and courses on the topic.