ABSTRACT
We have previously highlighted the important role of areas of `the primitive brain', the lower structures that are located deep within the brainstem, in the overall affective development of the person. In the higher structures of the brain are located those areas responsible for more complex information processing involving perception, meaning making, thinking and reasoning. The right orbitofrontal region in particular has been highlighted as particularly involved in the regulation of arousal patterns and in social and emotional behaviours (Barbas, 1995), and in the capacity of a person to be aware of themselves as a person with a history, known as autonoetic consciousness (Schore, 1994; Wheeler et al., 1997). The involvement of the right orbitofrontal cortex with the capacity to talk about one's history suggests the involvement of this region of the brain in the narratives derived from the Adult Attachment Interview (AAI) (Main et al., 1985), since the orbitofrontal region appears to be particularly concerned with the organization of emotional experience in the context of interpersonal relationships (Heller, 1993; Cozolino, 2002, 2006; Hart, 2008). In its mediating role between lower and higher brain functions, as well as its role in the regulation of body states, the orbitofrontal cortex becomes important as an integrating function for different kinds of communication from both external and internal sources. As Ogden et al. (2006) suggest:
In its function as part of the attachment action system, the orbitofrontal cortex is believed to enable cortically processed information concerning the environment (e.g. visual and auditory stimuli emanating from a facial expression) to be integrated with subcortically processed information in the internal visceral environment, thus facilitating the
in the overall executive management of emotional processing and action tendencies, damage to this part of the brain has been highlighted as particularly signi®cant if it occurs in the context of early developmental trauma (Schore, 2003a) particularly up to the age of two years. Early right hemispheric dysfunction involving the orbitofrontal cortex is therefore implicated in the development of disorganized attachment styles, post-traumatic stress and borderline personality disorders. Given the role of this part of the brain in the accurate management of empathy there is the possibility that early deprivation may also contribute to sociopathic personality disorders. This part of the brain is thus experience dependent and under optimal conditions of secure attachment and a sensitively attuned social environment develops in ways that support an adaptive capacity to ¯exibly regulate emotions or to autoregulate in the absence of social exchange or support. Neural development and functioning in this part of the brain also contributes to the capacity to understand and make sense of the minds of others, what Siegel (2001) describes as `mindsight', and which he links with other ideas such as the development of the mentalization capacity through attachment experiences (Fonagy and Target, 1997).
