Svrakic Dragan M, Zorumski Charles F
Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Department of Psychiatry, Taylor Family Institute for Innovative Psychiatric Research, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Front Psychol. 2021 Mar 15;12:583743. doi: 10.3389/fpsyg.2021.583743. eCollection 2021.
Recent advances in the neuroscience of episodic memory provide a framework to integrate object relations theory, a psychoanalytic model of mind development, with potential neural mechanisms. Object relations are primordial cognitive-affective units of the mind derived from survival- and safety-level experiences with caretakers during phase-sensitive periods of infancy and toddlerhood. Because these are learning experiences, their neural substrate likely involves memory, here affect-enhanced episodic memory. Inaugural object relations are encoded by the hippocampus-amygdala synaptic plasticity, and systems-consolidated by medial prefrontal cortex (mPFC). Self- and object-mental representations, extracted from these early experiences, are at first dichotomized by contradictory affects evoked by frustrating and rewarding interactions ("partial object relations"). Such affective dichotomization appears to be genetically hardwired the amygdala. Intrinsic propensity of mPFC to form schematic frameworks for episodic memories may pilot non-conscious integration of dichotomized mental representations in neonates and infants. With the emergence of working memory in toddlers, an activated self- and object-representation of a particular valence can be juxtaposed with its memorized opposites creating a balanced cognitive-affective frame (conscious "integration of object relations"). Specific events of object relations are forgotten but nevertheless profoundly influence the mental future of the individual, acting (i) as implicit schema-affect templates that regulate attentional priorities, relevance, and preferential assimilation of new information based on past experience, and (ii) as basic units of experience that are, under normal circumstances, integrated as attractors or "focal points" for interactive self-organization of functional brain networks that underlie the mind. A failure to achieve integrated object relations is predictive of poor adult emotional and social outcomes, including personality disorder. Cognitive, cellular-, and systems-neuroscience of episodic memory appear to support key postulates of object relations theory and help elucidate neural mechanisms of psychodynamic psychotherapy. Derived through the dual prism of psychoanalysis and neuroscience, the gained insights may offer new directions to enhance mental health and improve treatment of multiple forms of psychopathology.
情景记忆神经科学的最新进展提供了一个框架,用于将客体关系理论(一种心理发展的精神分析模型)与潜在的神经机制相结合。客体关系是心灵的原始认知情感单元,源自婴儿期和幼儿期阶段敏感时期与照顾者的生存和安全层面的经历。由于这些是学习经历,其神经基础可能涉及记忆,这里指情感增强的情景记忆。最初的客体关系由海马体 - 杏仁核突触可塑性编码,并由内侧前额叶皮质(mPFC)进行系统巩固。从这些早期经历中提取的自我和客体心理表征,起初因挫折和奖励互动引发的矛盾情感而二分(“部分客体关系”)。这种情感二分似乎在杏仁核中是基因固有的。mPFC为情景记忆形成图式框架的内在倾向可能引导新生儿和婴儿对二分的心理表征进行无意识整合。随着幼儿期工作记忆的出现,具有特定效价的激活的自我和客体表征可以与其记忆中的相反表征并列,从而创建一个平衡的认知情感框架(有意识的“客体关系整合”)。客体关系的具体事件会被遗忘,但仍会深刻影响个体的心理未来,其作用如下:(i)作为隐性图式 - 情感模板,根据过去的经验调节注意力优先级、相关性和对新信息的优先同化;(ii)作为经验的基本单位,在正常情况下,作为功能性脑网络交互式自组织的吸引子或“焦点”进行整合,这些脑网络构成了心灵的基础。未能实现整合的客体关系预示着成人在情感和社交方面的不良后果,包括人格障碍。情景记忆的认知、细胞和系统神经科学似乎支持客体关系理论的关键假设,并有助于阐明心理动力心理治疗的神经机制。通过精神分析和神经科学的双重视角得出的这些见解,可能为增进心理健康和改善多种形式精神病理学的治疗提供新方向。