|
|
DISORDERS OF ARCHETYPAL PROPENSITIES
Background:
Stevens & Price (2000) suggest that natural selection has equipped us with lifespan-specific context-sensitive archetypal propensities to navigate biosocial imperatives (or "goals" or "social roles") that facilitate inclusive fitness. They emphasise that genes are conveyers of potential for species-characteristic behaviours, rather than rigid determinants of social behaviour. Stevens & Price argue that human psychopathology & suffering result from failure to meet biosocial imperatives by the archetypal propensities. This is a developmental view of psychopathology, which predicts disorders occurring not only at the time of the instance of failure to meet the biosocial imperative by the particular archetypal propensity, but also downstream to the failure due to the resultant organismic behavioural dysfunction. The development of a major disorder itself may interfere with the individual being able to meet the next biosocial imperative that arises in the individual's next life stage, thereby leading to more disorders developing. A cascade of disorders may emerge from an upstream block or insult, explaining why comorbidity is so common in individuals with mental disorders. For example, some failure of the Attachment Archetype to lead to an individual obtaining secure attachment with a parental figure, may cause a number of severe mental disorders, in view of this being a crucial developmental requirement in order for the attainment of basic adaptive behavioural repertoires by the individual. For example, the ability to develop a reasonable degree of self-esteem, the ability to self-regulate affect, the development of mature coping mechanisms & the acquiring of a balance between vigilance for danger & lack of tendency to over-response to aversive stimuli. The general importance of attachment is discussed below. Because meeting this biosocial imperative provides such a crucial footing to human behaviour in general, failure to adequately meet the attachment imperative will reduce the likelihood that the organism will be able to effectively meet the next developmental challenges, that of defence, dominance-striving & reproduction.
| ||||||||||||||||||||||||||||||||||||||||||
| Stages | Consequences | Possible down-stream psychopathologies |
| Protest | Anxious attachment Separation anxiety Excessive demands on others Anxiety & anger when demands not met |
Neurotic anxiety Dependent personality Hysterical personality |
| Despair | Grief, mourning Depression |
Depression |
| Detachment | Defensive posture Excessive self-absorption & self-reliance Difficulty achieving social integration Blockage in capacity to make "deep" relationships |
Schizoid
personality Sociopathic personality |
Bowlby (1969) hypothesised that the infant's ‘capacity to cope with stress’ is correlated with certain maternal behaviours, and that attachment outcome has consequences that are ‘vital to the survival of the species.’ According to Bowlby the effect of an atypical environment is that development is diverted from its adaptive course.
Bowlby said: "In the fields of aetiology and psychopathology, attachment [theory] can be used to frame specific hypotheses which relate different family experiences to different forms of psychiatric disorder and also, possibly, to the neurophysiological changes that accompany them" (Bowlby 1978).
Bowlby's speculation that, within the attachment relationship, the mother shapes the development of the infant's coping responses is now supported by a large body of experimental studies that characterise maternal care and the development of abnormal stress responses (Schore 2002),(Morgan 2001).
Developmental psychopathology, an outgrowth of attachment theory that conceptualises normal and aberrant development in terms of common underlying mechanisms, has become a leading paradigm in the understanding of the pathoplasticity of mental disorders.
Main and Solomon (1986) studied the attachment patterns of 12-month-old infants who had suffered trauma in the first year of life. This led to the discovery of a new attachment category: Disorganised-Disoriented Insecure Attachment, found in 80% of maltreated infants. They concluded that these infants were experiencing low stress tolerance, disorganisation & disorientation reflecting the fact that the infant, instead of finding a haven of safety in the maternal relationship, was alarmed by the parent. They noted that because the infant inevitably seeks the parent when alarmed, any parental behaviour that directly alarms an infant should place it in an irresolvable paradox in which it can neither approach, shift its attention, or flee. The behaviours generalised beyond interactions with the mother, with a heightened intensity of dysregulated affective state when the infant was exposed to the added stress of an unfamiliar person. These infants were unable to generate a coherent behavioural coping strategy to deal with this emotional challenge, displaying simultaneously contradictory behaviour patterns as brief interruptions of organised behaviour. The behaviours were considered manifestations of an impaired regulatory system, one that rapidly disorganises under stress. It was highlighted that 12–18 months is a critical period for corticolimbic maturation, involved in attachment behaviour and state regulation.
Schore (2002) argues that the developing infant is maximally vulnerable to suboptimal environmental events in the period of most rapid brain growth. During these critical periods of genetically encoded synapse overproduction followed by environmentally driven synapse elimination, the organism is sensitive to conditions in the external environment, and if these are outside the normal range a permanent or semipermanent arrest of development occurs.
Disruption of attachment bonds in infant trauma leads to a regulatory failure, expressed in an impaired autonomic homeostasis, disturbances in limbic activity, and hypothalamic and reticular formation dysfunction (e.g. hyperarousal, avoidance). The concept of disorders of affect regulation is consistent with a growing realization in medicine and psychiatry that many illnesses and diseases are the result of dysregulations within the vast network of communicating systems that comprise the human organism (Taylor et al 1997).
Only a third of abused & neglected children in clinical settings, however, meet DSM-IV's diagnostic criteria for PTSD. The most common diagnoses in these children are: separation anxiety disorder, oppositional defiant disorder, phobic disorders, PTSD & ADHD. Therefore, none of the diagnoses capture the pervasive problems with attachment, attention & physiological arousal that characterise these children (Van der Kolk 2001).
Supporting the view that frustration of archetypal intent may lead to the development of a range of disorders downstream due to effects on relevant developing neural circuitry, is the model that abused & neglected children develop Complex PTSD, rather than the DSM-IV defined syndrome that commonly develops following exposure to a single traumatic experience. It is noted that the capacity for self-regulation is profoundly impaired. Van der Kolk has written extensively on Complex PTSD.
Chronic affect dysregulation is commonly associated with substance abuse, chronic anxiety & depression & problems negotiating satisfying interpersonal relationships. Being able to engage in competent social relationships has been shown to be an important prognostic factor in capacity to recover from further traumatic experiences. A reduced ability to tolerate stressors may lead to their managing their overwhelming distress with self-destructive behaviours such as self-injury, substance abuse, eating disorders & suicide attempts. Loss of self-regulation may also lead to attentional problems, difficulty with stimulus discrimination & inability to inhibit action when aroused. These features may account for the high comorbidity between PTSD & ADHD, in addition to borderline personality disorder, somatisation disorders, dissociative disorders & eating disorders (Van der Kolk 2001).
A:
