How Relationships Shape Your Brain | Dr. Allan Schore

Welcome to the Huberman Lab podcast where we discuss science and science based tools for everyday life. I'm Andrew Huberman and I'm a professor of neurobiology and Ophthalmology at Stanford School of Medicine. My guest today is Dr. Alan Shore.

Dr. Alan Shore is a clinician psychoanalyst and he's the world expert in how childhood attachment patterns impact our adult relationships, including romantic relationships, friendships and professional relationships, as well as our relationship to ourselves. Dr. Shore is on the faculty in the Department of Psychiatry and Behavioral Sciences at the University of California, Los Angeles School of Medicine.

He is also the author of several important books including Right Brain Psychotherapy and Development of the Unconscious Mind. Today's discussion with Dr. Shore is an extremely important one for everyone to hear, to understand themselves and to understand the people in their lives. Why?

Well, we. We all go through the first 24 months of age. You wouldn't be listening to this if you hadn't. And during that first 24 months of age, your brain develops in a particular way depending on how you interacted with your primary caretaker, namely your mother, but also your father or other primary caretakers.

In that first 24 months, your right brain and your left brain mediate very specific but different processes. For instance, today I learned from Dr. Shore that your right brain circuitry, that is specific circuitries on the right hand side of your brain, are involved in developing a very specific type of resonance with your primary caretaker that transitions from states of calm and quiescent that you both share simultaneously, to states that are considered up states of excitement, of enthusiasm, of being wide eyed, and the transitioning back and forth between Those states, as Dr. Shore explains, is critical to our emotional development and how we form attachments later.

So if you've heard, for instance, of avoidant attachment or anxious attachment or secure attachment today, you'll understand why those particular attachment styles develop, how they translate from early life to your adolescence, teen years and adulthood, and in fact, how those childhood attachment patterns, which of course we can't control for ourselves, but we can control for our children, how we can modify them through very specific protocols in order to achieve better relations with both others and with ourselves. It's indeed a very special conversation and to my knowledge, unlike any other discussions about relationships, neuroscience or psychology that certainly I've heard before, and I fully expect that for you it will be as well. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desired effort to bring zero cost consumer information about science and science related tools to the general public.

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Again, that's Eight Sleep.comHuberman and now for my discussion with Dr. Alan Shore. Dr. Alan Shore, welcome.

Nice to be here. To kick things off, I have a simple question which is what percentage of our thinking and our behavior do you think is governed by our conscious mind versus our unconscious mind? You understand that I was trained in psychoanalysis and I'm a psychodynamic psychotherapist in addition to a scientist and neuroscientists. So the unconscious has been something that I have been aware of and I've been writing about.

It's the central part of what I'm writing about to this day. Essentially, as we're going to see, I'm suggesting that the right brain is the unconscious mind. So when you ask how much of things really are conscious and how much are unconscious, I'm also looking at that neurobiologically in terms of how much of activity is going on in the right brain. The right brain is always processing information, always.

Especially emotional information at levels beneath conscious awareness, especially when you're in an emotional interaction. So how much really are things unconscious? I would say that when it comes to the basic motivations of why we do what we do, 95 to 90% of that is unconscious. And there has been data to show that that is the case that most although we think that our conscious mind literally is making all of these decisions underneath at all points in time, the unconscious is operating.

Used to be thought that the unconscious only comes forth in dreams at night. We now know that this right brain is reading unconscious communications between us. Communications Is it safe to be with you? Do you understand what I'm saying, really the critical ones always operating and much more important than we have thought itself.

Let's start thinking about and talking about this right brain versus left brain thing. And what I'd like to know is when we come into this world, how much lateralization, as we call it, how much right versus left brain specialization is there at the time when we exit the wound, when we take our first breath? The answer to that is pretty clear at this point in time. And incidentally, some of these questions about the unconscious are provided by neurobiology.

But essentially, here's what we know. There was discoveries that were being made in the 80s and the 90s about the human brain growth spurt. The human brain growth spurt occurs from the last trimester of pregnancy through the second until the third year of life. All of that time is a period of right hemisphere dominance.

And actually, there have been six major studies in neuroscience laboratories around the world that have shown that the right hemisphere is dominant during that period of time. In fact, there's a recent study in Mexico where They looked at 2 to 3 months, 6 to 8 months, 9 to 12 months. At each point in time, they noticed that the right hemisphere was accelerating its growth. The left was not.

So the right is dominant very early. In fact, there's evidence to show that even in utero there is a right lateralization. And remember, lateralization is part of all systems. And what is lateralized is not only the cortical areas, but the subcortical areas, etc.

So if you take, let's say the amygdala, there's a difference between the right amygdala and the left amygdala. And again, the right hemisphere. So the answer to that is very clearly now, the left hemisphere does not come into a growth spurt until the end of the second year and into the third year up until that point, which means everything about attachment is about right brain dynamics. Does that mean that everything about attachment is occurring in the first, you know, 24 months?

Yes, absolutely. And it's occurring during that brain growth spurt while the right hemisphere. So essentially what you have now is that in the baby's brain, that baby's brain is now in a right brain growth spurt. And the mother now is shaping that baby's right brain through the attachment mechanism, through her regulation of that brain.

So she helps shaping that brain for better or for worse. And incidentally, that means also not only secure attachments, but also the matter for better or worse, it's also the early evolution of insecure attachments. And we'll talk about what those insecure, tactical, all of those really are being shaped by the right. What's more, there's evidence to show that it goes right hemisphere, then it goes left hemisphere, and then it goes back into left and back and right along the lifespan.

So although you have a tremendous growth spurt, more than any other time, in the first two and a half, three years of life, think now about adolescence, where you have another growth spurt. Is adolescence marked by a right brain growth spurt? It's marked by the initially right, and then it goes left. So essentially, with puberty and with the onset of testosterone and androgens and estrogens, it shifts now into another growth spurt at that point in time, which means, just for the record now, the attachment relationship, which is essentially going to be about how we regulate our emotion, because I'll be talking about attachment is about the communication of emotions, right brain to right brain in the first two years of life, and about the regulation of emotions in that same period of time, et cetera.

But ultimately, that leads to the strategies that we have for affect regulation. And attachment is essentially affect regulation, affect communication and affect regulation. So now what you're looking at is you have a mother and an infant. They are communicating with each other right brain to right brain.

And how are they doing it? By face, voice, and gesture. The mother is now reading the expressions of the baby's face. The visual, the auditory, the prosody of the voice, and then the tactile.

So she's picking up these kinds of communications that are coming out of that baby. Tactile, gestural, visual. And she's now picking up those communications. Now she's resonating with those communications, and then she's going to regulate those communications.

And that's essentially what it's about. In the end, what we have is strategies of affect regulation. How we regulate affect for the rest of our lives depends upon the attachment relationship of the first two years, which is a right brain to right brain connection. Now, there have been hundreds, thousands of studies on attachment, as you're well aware of at this point in time.

But the key to it, literally, I began this in 1994 with my first book, Affect Regulation and the Origin of the Neurobiology of Emotional Development. Okay, Remember, Bowlby was studying attachment in the 60s, but the problem of emotion really was not picked up. And early on, when they were looking at attachment, they were looking at behaviors and they were looking at cognition. So if you know the attachment, literally remember the strange situation.

Yeah. Just to remind Listeners, I've talked about this on previous podcasts. I'll provide a link to that segment. But a strange situation can briefly be described as parent and usually mother and child coming to the clinic.

They deliberately leave the baby with a caretaker. This is sort of a pseudo daycare type situation. Mother leaves. And then there's a lot of attention paid to how the infant or young child, toddler, whatever age they're looking at, reacts.

Are they nervous? Are they able to engage in play? And then they look at the return of the mother and how they react to that. And there was this classification of behaviors along the lines of secure attached, insecure attached.

There was a categorization of kind of an amalgam of different things, these so called D babies that were kind of a bunch of other things. And this is where we hear a lot nowadays about secure, insecure and anxious and avoidant adult relationship styles. There's been a lot written about that and talked about that. We don't have time to go into all that detail, but this is what Dr.

Shore is referring to. I'm really intrigued by this idea that there's a right brain, left brain dominance that takes place throughout the lifespan. Has it been carefully mapped into adulthood such that we can say as a functional chronological age, you know, when somebody hits their early 30s, that they're more right brain or left brain dominant? Or is it more developmental milestones as opposed to chronological age?

I think it's developmental milestones there. You know, I'm thinking that. Remember Eric Ericson talking about different stages of life and how you have a hierarchy here, literally, because the attachment is a hierarchy, it starts subcortical and then goes to cortical. So what he said was that there are changes along the line and that it fits with that.

So the attachment relationship is there at later points in time. And really what it does, it guides us through our relationships with other people. It certainly guides us through strategies of what to do with stress. And that way that we deal with that stress is now going to depend upon how the mother is regulating that baby's stress during a critical period.

Now, the term critical period is an important one here too, because again, at the first two years of life, it's the right brain is in that critical period there. But that leads to strategies of affect regulation, how we deal with stress, but also how we deal with novel situations. And again, all of it has to do with emotion. Now, I jumped there because I talked about there was attachment models move from behavior to cognition to emotion.

And essentially the first book that I wrote was on the neurobiology of emotional development. And in 1994, when I came out with that book, that was about the same time that Antonio Damasio came out with his book. And really, it was not until the mid-90s, partly because of the neuroimaging which was coming during, you remember, the decade of the brain, that emotion really now became a matter that science was looking at for the first time. The point that I'm making here is that attachment is not psychological, it's psychobiological.

And there was always this rift between the psychological and the biological. But when you're talking about emotions, you're not only talking about psychological events, you're talking about physiological events that are associated with those events. For example, the physiology of the stress response, the physiology of the sympathetic nervous system, which is energy expending, and the parasympathetic nervous system, which is energy conserving. So the mother is a regulator of that.

And the way that she's a regulator of that baby is that she's tracking that baby's arousal levels, she's tracking that baby's emotions as they change in time, moment to moment. And then she's synchronizing with that, and that allows her now to be able to regulate it. So we're going from recognizing that baby's emotions, synchronizing with those emotions, and then being an affect regulator. So the mother, who was securely attached, now is a good affect regulator of that baby.

She not only is an affect regulator of the negative states of the baby, because negative states and negative affects are adaptive by definition. BABY cries, MOTHER NURSES BABY and that's a signal she's sending there literally. And the mother then intuitively knows, intuitively knows she's not using her left brain to figure out what to do with that baby. She's doing it intuitively.

And intuition is a right brain function, and she's regulating that baby implicitly. Now let's go back implicit to explicit. Okay, you're seeing a lot now about the shift from explicit to implicit. Something that is implicit goes on at levels beneath awareness.

So when she is intuitively knowing what to do, that right now this baby is down regulating too much and she wants to bring that baby up, she'll now use her tone of voice literally to raise that baby up into a more excited state. Or if the baby is dysregulated, sympathetic hyper arousal, she knows how to downregulate that. And she'll down regulate that by her facial expression, by the tone of her voice. Now her tone of the Voice is now trying to soften and to quiet down.

So, so essentially what attachment is is the regulator of arousal, of emotional arousal. And that emotional arousal also includes the autonomic nervous system. So what we have here is the regulation attachment of the limbic system, the emotion processing limbic system, positive and negative, and the autonomic nervous system. So they are limbic autonomic circuits.

And those circuits are in the right brain. Now on this matter, as it turns out, the right brain has a control system of attachment. Now since the right brain is there first before the left because there's no speech at 2 years, she's regulating this baby at 2 months, 6 months, 12 months, all of it is occurring non verbal. She's doing this implicitly, not explicitly.

The left hemisphere processes explicit stimuli, conscious stimuli, rational stimuli. That's not there. Everything is being done implicitly beneath levels of awareness. And again, that allows her to be the regulation.

So attachment theory, my attachment theory, regulation theory is essentially attachment is interactive regulation. Stay with me. Now ultimately what we have are two forms of regulation. What we're doing is we're regulating the self, right?

I mean it's the subject itself which is in the right hemisphere. The left is object itself. The left is verbal conscious. She's regulating the right hemisphere.

And she's doing that again by tracking the baby's emotional states, as I said. But again, what the child learns now from that is that her right brain is becoming more and more complex from the first year to the second year. And it's going to turn out some of these functions that are more complex are being also stimulated by the mother. And ultimately by the end of the second year, that baby can regulate its emotional states by itself in its right brain.

But we have two forms of regulation. You can regulate your states by auto regulation by yourself. In other words, you're not with other human beings at this point in time. You have an efficient right brain which can regulate.

And essentially what we're talking about here is the regulation of the amygdala by the right orbital frontal cortex. The right orbital frontal cortex is the highest level of the right hemisphere. It's also has the most sophisticated and the latest evolving parts of the brain are in the right frontal cortex, not the left. The right orbital frontal, not the left dorsolateral cortex is the key to this.

So what we learn from attachment here again is how to both in a cigarette attachment, how to auto regulate your emotions when you're apart from people. In other words, when you go to a quiet place at this point in time, you're regulating yourself down, so to speak. And you're getting a nice regulation of the amygdala by the right orbital front cortex or interactive regulation, which is now you go to another human being. We go to another human being under times of stress, in an optimal situation, we also go to another human being to share joy states.

Remember I said that the mother is upregulating joy states and down regulating negative states. So in a secure attachment you have somebody now who can do both. In certain forms of insecure attachment, that's not going to happen. The avoidant attachment is always auto regulating his states.

So just so I'm clear, in avoidant attachment, the baby, which is now, let's say two and a half years old, that's already a toddler. That's a toddler, excuse me, the toddler is auto regulating more often than seeking another to help do coordinated regulation. Yeah. What I'm saying is a secure attachment.

And let me back up, step on it. The key to attachment is psychobiological attunement. You know the phrase notice psychobiological attunement, that the mother is regulating not only the psychological aspect, but literally as regulating the physiological aspect of that, which means that she's regulating the autonomic nervous system. Think about gorgeous social engagement system.

What we have here is the capacity by insecure attachment who have. And then the second part of the attachment is repair. Let me go back. Psychobiological attunement.

Sometimes she misattunes, sometimes she misreads. The baby states for one reason or another, what happens in a good enough caregiver is that the mother who has misattuned now reattunes to that baby, now resynchronizes with that baby, now reconnects right brains to right brains with that baby. And that repair is a key here. So you have misattunement and repair.

So the key to a secure attachment is not only psychobiological attunement, but it's also the repair of the misattunement. And that allows the baby now to expand that situation and being able to use that now to order the case, that's a secure. But if she misattunes, for example, and doesn't repair, let's say, or she's not that good at psychobiologically attuning, let's say, as an avoidant mother, because her avoidant personalities are uncomfortable with real closeness. Another term for an avoidant personality is a dismissive personality.

And what they are dismissing is the need for interactive regulation. So they're always auto regulating or you have another time in which you have another form of attachment, an insecure anxious attachment where that person is always interactively regulating or is always going to others to help them regulate but can't auto regulate. I think this is a really important thing to hover on for a moment, just given some context about hundreds of thousands of questions that I get about avoidant versus secure versus anxious attachment. And you stated it all incredibly clearly.

But I want to make sure that we double click on this. As they say, the idea that if a child and mother did not coordinate their autonomic regulations, synchronize did not synchronize their autonomic regulation in the proper way that there would be a non secure attachment. I'm using that language for a specific reason makes total sense. But this idea that if the child which the baby which is a toddler at three or so is avoidant, then they're going to have to learn to auto regulate and they're going to seek others to help them regulate.

Less than a secure attach. And the anxious attached baby toddler adolescent adult would do just the opposite. They're a hard time self soothing but they are going to feel, let's say that these might be the kind of people that don't well tolerate a text message not getting responded to at a very short latency, for instance. And we all, we all depending on context, we have this right.

But I find this to be incredibly important, which is why I wanted to go back through it because I think nowadays we hear so much about anxious and securely attached, avoidant, etc. In the context of adult romantic relationships. But I hope that people are realizing the truly incredible importance of your work which is that the same circuitry and mechanisms that are used to establish infant mother attachment are repurposed later in life for adult relationships. I think that when we hear that it makes sense.

But I don't think that most people know that. They assume somehow that there's circuitry in our brain and body for adult romantic attachment that is distinct from our attachment circuitry that we had with our parent. And I think your work speaks very loudly that they are in fact the exact same. All of this is happening in the right brain and this is going to be attachment relationship is retained as an autobiographical memory in the first two years of life.

18004 There's a left hemisphere and that under later stress situation that would be the key there. Incidentally, the attachment, whether it's secure or insecure, is also the key to positive and negative transferences. That's what it's communicated. Let me go back and say a little bit more about one other form of attachment and that you mentioned.

The type D attachment, the D babies, these are disorganized babies. So you have secure. You have two types of organized insecures, okay, the avoidant and the anxious. And then you have a disorganized, disoriented one.

Now, ultimately, that person under stress is not able to autoregulate or to interact, regulate. So what they will do at that point now, now I'm now thinking about, let's say PTSD or various borderline personality disorders. That person now literally can't go to the other order regulation or interactive regulation. That person now will use a defense, literally to shut down the attachment system.

And that's exactly what dissociation is. Dissociation just shuts down the attachment. So in the anxious attachment, you have a continual activation of the attachment system, which means a continual activation of the right hemisphere all of the time. And in the insecure, dismissive attachment, you have a deactivation of the attachment system, which would be a deactivation of the right brain.

And so in the end, a secure attachment is an efficient one, but it's an efficient one that can switch back and forth between them. Not only that, it also, at a later point in time, when the left comes online, it can also communicate much better with the left hemisphere, you know, than without that. Regulation theory is essentially a theory of the development of the self in an optimal situation. But it also talks about the psychopathogenesis of the self, the early origins of psychiatric disorders and personality disorders.

I'm thinking about not only schizophrenia and depression, but I'm not thinking about narcissistic personality disorders, borderline personality disorders. Maybe we'll come back to more on that. And then ultimately the repair of the self. So regulation theory is about the development of the self, the psychopathogenesis itself, and then the repair of the self.

Because these attachment situations are now going to play out under all periods of stress. The right hemisphere is dominant for the stress response. The right hemisphere is dominant for the sympathetic nervous system, the energy expending. And the right hemisphere is dominant for the parasympathetic nervous system.

So again, all of that will play out at later points under stress. And when those systems break down, that's when the patient will form symptomatologies and come into therapy. And in therapy, the therapist. Now, the key.

I'm jumping here. No, this is great because there's a right brain to right brain interaction between the mother and the infant. There's also a right brain to right brain interaction between the therapist and the patient. And the key to both of them is regulation.

Person is coming into this regulated state. The key to that is regulation. And the key to any form of therapy, whatever the form of it is, again, is interactive regulation. And it's a therapeutic relationship.

The thing which is the best indicator of whether somebody will do well out of therapy and whether a clinician will do well out of therapy is how well they can deal with the therapeutic relationship. And a really good therapist literally knows how to bring back those attachment things there because now the person is starting to feel safety and trusted. And incidentally, attachment is about safety and trust, which is very much autonomic. But again, here, the key to therapy is being able to form a therapeutic relationship with the patient.

So the key here is, can the therapist form co create a therapeutic relationship with an avoidant patient, with a secure patient, with anxious patient, with a borderline patient? As you can imagine, the toughest thing is going to be able to do with the borderline patient or the schizophrenic patient. So what you have here is that the attachment dynamics are yelling at. So in the very first session, what's happening, the therapist is listening to the verbalizations of the patient in order to diagnose and understand the symptomatology.

But the therapist is also listening beneath the words, and the patient is tracking the attachment relationship underneath it, tracking the arousal and the arousal dysregulation underneath that, tracking it in his own body, so to speak, etc. And again, that is a different type of listening. Again, the therapist is listening to a left brain, but more or less the therapist is listening to the right brain. And the question is, how does the therapist do that?

And in order, just with regard for the therapist to be able to get to the attachment dynamics, which are right lateralized, the therapist's got to switch out of left into the right. And there's a term for that. The term for that is surrender. Surrender.

You cannot consciously, purposely put yourself into the right. You've got to let go. You've got to let go, think, let it be, so to speak. I'd like to take a quick break and thank our sponsor, AG1.

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Tell me more about surrender, and I just want to make sure I understand this is surrender on the part of the therapist, trying to, yes, listen to the narrative that the patient is sharing, but also paying attention to the underlying emotional state. Is the person quaking? Are they angry? Is there feelings of despair, shock?

So they're carrying this in their parallel tracks? And then is the goal of the therapist, if they're an effective one, to then soothe the patient, or is it to allow the patient to have some sort of catharsis, some release of this? Like, at what point does the therapist intervene and try and coordinate and show that the patient have different. A different way to think about and feel about the topic?

What I'm suggesting here is that essentially the therapist is listening left brain to left brain, but the therapist also is always listening beneath the words, et cetera, and he's listening to the right brain, to right brain communication. And the patient now who's depressed is coming out with right brain communications. There's sadness in the voice, the face is clearly dysregulated. And essentially as the therapist is tracking that, the emotional arousal, whether it's into hypo arousal and depression or hyper arousal, you know, into anxiety, the first thing there is to synchronize with that patient so that my physiology is syncing with their physiology.

And now through the right insula, interoceptively, I now literally am feeling in my body what the patient is feeling in their body. I now understand that patient from the inside out. And incidentally, what I'm picking up in my body about the dysregulation of that patient may be very different from the verbal report that that patient is giving at that time. But the key here, literally, just like the mother, is synchronizing with that baby's crescendos and the decendos of that autonomic state, of those emotional state.

I'm picking up those points where they are shifting into and out of an emotional state. I'm synchronizing with that. And then ultimately, when I'm in sync with that kind of thing, then at that point, purely implicitly, I'm now starting to slow the tone of my voice. If I want to reduce that arousal down or I'm up regulating the voice at that point in time, I am now interactively regulating.

And we are now synchronized together. So essentially what's going to happen is that as we synchronize, as they go into dysregulation, we're now synchronizing together as we're going down into, into regulation. So the therapist can literally and somatically show the patient what autoregulation is like or what coordinated regulation is like. And you'll see it on my face.

Face, voice, gesture. You'll see it on my face. You'll see it in the tone of my voice, you'll see it in my gestures. Those three sensory modalities are now going back and forth between us.

So the key of the first session literally is not only to diagnose really, it's to start to begin to synchronize with that patient and to form a therapeutic alliance with that patient. And at the end of the first session, the patient may say, I don't know why, but I'm feeling better. And I have some idea that you can understand, but it's got to be more than that, what I am feeling literally. So often nowadays, I think we hear that adult romantic relationships can provide a healing of some of the failures of childhood attachment.

And there's also a phrase thrown around a lot that we need to learn to parent ourselves. This is more of a pop psychology online social media thing that people need to learn to mother and father themselves at some level, to self soothe and to who knows what that means. I'm not trying to find it operationally defined. So the question I have is, to what extent do you think the process that you just described with a therapist can start to rewire some of the capacity to auto regulate or coordinated regulate?

Essentially here what you have is over time, partly because of this synchrony. First of all, let me spell synchrony with the capital S. What I mean by that is in the last five years, a huge amount of information has come out about this idea about interpersonal synchrony. The term synchrony comes from the Greek sync, meaning the same chrony time, same time.

So that literally two people literally are synchronized in the same. We are feeling something in the same moment, and we are feeling it spontaneously between ourselves, we are feeling that kind of situation. So again, here, the key to the mother, really, even more than the order regulation, the key is interactive regulation, number one. Number two, it's occurring at an implicit level.

The mother literally is doing this without any conscious awareness. She's doing this intuitively. The right hemisphere is intuitive. It's majestic.

It's not rational and logical. The key to any disorder, whatever it is, is the regulation of a particular state. The regulation of rage, the regulation of loss, the dysregulation of shame and disgust. So essentially what you have is the regulation of all of these emotions.

But that regulation, I want to point out, is all implicit. And here's where. The skill of being with patients over long periods of time is the key here. Because the key to making changes in the patient is not what you say to the patient or what you do to the patient, it's how to be with the patient.

You understand the difference how to be with that patient, especially while that person's being is in a disregulated state. Now, by definition, when they're coming in the first session, they are in a disregulated state. So again, it's implicit. It's not explicit.

If explicit regulation is. Is an intellectual understanding of my symptoms. Implicit is an unconscious understanding at a physiological level, at a psychobiological level of that. And it's an.

Ellie, synchrony is right. Is a mechanism underneath empathy. Now, we know empathy literally has to be there. But empathy is a right brain function and there is a difference.

I said there's a difference in the hemispheres. There's a difference between emotional empathy, where I am feeling what you are feeling and we are sharing the same feeling. And I don't have to think about that literally. I know at that point in time we are in the same place.

There's a difference between emotional empathy on the right and cognitive empathy on the left. Cognitive empathy is an understanding. It makes no changes because essentially what we're attempting to do is make the changes in the right. Now the changes in the right are going to be in the right axis.

They're going to be the orbital frontal cortex, which is the executive regulator of the right brain. The dorsolateral cortex is the executive regulator of the left brain. The orbital frontal cortex now starts to form new connections with the cingulate, the insula and the amygdala. And that's where you're now going to see the changes.

But again, the changes are due to the regulation. So you'll see the person now starting to come into more regulated states. And the key is synchrony. So what's happening here?

There's a strong therapeutic alliance, safety and trust. And in that situation now, the more synchrony that is there between the two, the more interactive regulation there is between the two. And first there will be synchrony between the patient and the therapist. Then there will be synchrony and interact regulation between that person and maybe other people, maybe a wife or partner.

And ultimately in the symptomatology will change, because remember, the symptomatology is dysregulation, and the whole key is to change it to regulation. It's fascinating. There are a couple questions I have before we move forward about mother infant attachment as opposed to father infant attachment. So that's one.

And I'll ask these again in a moment, but I think you'll see where I'm going here. And then I'm fascinated by the idea that these circuits get established early in life, then are repurposed for adult relationships. They can be modified in the way that you just described, but that they cross gender and gender lines. So for instance, a female baby can form these patterns of attachment with their mother female caretaker.

But then assuming that baby grows up to be a heterosexual woman and she has attachments to men, then these things can be reactivated across gender lines. Right. So this formation of the circuitry is not gender specific, although it sounds like it's important that it be the mother to child in some way. You keep saying mother child is supposed to caretaker, so to just spell them out one by one.

First question, are there any data about the formation of these circuits in the baby where the mother is either not available if it's an adopted mother, if it's a child raised by extended family? I mean, there's so many different configurations, but you get the point. All right. Here's what I'm suggesting.

First of all, there has been some conflict on this, but after 30 years on this, I believe that there is a primary attachment figure. And the primary attachment figure is the person who is the interactive regulator of that baby when that baby is under stress between age 0 and 2. Yeah. Or let me say it in another way.

The primary attachment figure is the person who provides the right brain for that baby when that baby's right brain is this regulated. Could be dad, could be mom, could be. Yes, it's true, women are better at reading nonverbal cues than men are, but it could be. And incidentally, we now have some evidence that's showing that men do have right brains.

For a second there, I wasn't sure if you were joking, but I don't know, maybe that's reflective of a naturally right brain. Now, that being the case, what's happening here is that in the first year or two, the mother's right brain, she is the person who is the right brain, which in most cultures is a woman. But it doesn't have to be. It could be a stay at home dad who literally has a good right brain.

And maybe a couple are figuring out that literally he'd be better in that position. But if he's that right brain. But other than that, what happens here when it goes now into the second year till the end of second year and the father comes online? Got me.

At that point in time, the father now becomes a primary attachment figure also. But he has some differences the way he's dealing with that baby. He's usually more arousing with that baby and that the play is more arousing with that baby. So more activation of the sympathetic autonomic.

So sort of more up, let's call it up level play. Exactly. You're dealing with more up regulation and being able to tolerate more hyper aroused states. Because in the second year, one of the things that the father will do with the infant is with toddler infant, first year toddler, second year, rough and tumble pay, for example, rough and tumble play.

So the father is that. So the father literally is now teaching the child literally how to take risks. But the father is now moving more towards autonomy and independence. The mother was there at the beginning about interactive regulation.

So the father is playing that role. And I've also suggested that just as the mother is shaping that baby's right brain in the first year, the father is now shaping that baby's left brain towards the end of the first year, second and into the third year, that he's shaping that baby's, his left brain to that baby's left brain. That being the case, he may also earlier on have had good experiences with that baby early on in life. And a good example of that would be a father who is tender, tender, yet at the same time is instrumental and is teaching things about the world.

So one brain is shaped by the mother figure, the brother by the father figure. What about under situations where there's really just one primary caretaker? This is increasingly common nowadays. And in some countries, like in certain Scandinavian countries, people opt to do this.

And elsewhere, of course. But this isn't always a divorce situation. Sometimes people decide to have children on their own. You know, I think what's happening in that kind of situation is the person is initially providing the right brain and then that person is now providing the left brain.

So let's say a single woman with a child, her right brain is there on the get, but then in the second year, and then suddenly there may be father figures or family members who also can step into that. But essentially her left brain is there also. Remember, we both have right brains and left brains. But again, that's a different kinds of skill in a left brain, which would be, you know, the more autonomous situation.

What are your thoughts about some of the modern exploration of compounds that can facilitate more right brain synchrony between therapist and patient? I've done a few episodes about MDMA assisted psychotherapy. These, of course, were just recently not approved by the fda. So these are not legal.

Nonetheless, they're interesting clinical studies showing that these are empathogens. One could imagine that they could be useful in the proper context to improve patient therapist right brain synchrony and accelerate some of this process. But it seems like it would also require both the patient and the therapist taking the compound. And that seems like it would have all sorts of ethical issues.

Remember, it's a relationship in the end, there is a key there. I'm thinking I'm also somewhat aware of that literature. And you use the word empathogen, you know, which is not quite straight out empathic, but mimicking those kind of situations there. My thought is that that might be more efficacious if it were specifically involving right brain dynamics with a person who knew how to work with those right brain.

What you're getting there are very early forms of behaviors which are subcortical. Remember, the attachment is also regulating the subcortical areas, and those are the key ones. And incidentally, we're paying too much attention to the cortical area. We Literally have to shift because the subcortical areas are the foundations of the human, and everything is built on top of that.

I'll come back to in utero in a second if I get on that. In fact, some people who have worked with me have also been using right brain type psychotherapy in that with those patients. And I think that that will be really interesting possibilities of seeing changes where you have the relationship, you know, in addition to that and also some understanding about how the right brain works. Because one of the problems that you have where there's still some resistance to the idea that the right brain is just a simpler version of the complex left hemisphere, but that's not the case.

This right brain is working completely differently. So I'm thinking that in that case, a better situation, before I forget this, I want to just throw one of the pieces in. I said that the right brain is in a growth spurt from the last trimester. In the last five years, 10 years, there has been a real interest in utero development and evidence to show that you're even seeing lateralization of the fetus.

And so, and there's even evidence now, scientific evidence to show that the early memories in utero are stored in the right amygdala. So they're down there, so to speak. So we're not paying more and more attention to what is happening there. Because at birth, literally what you have here is the deeper parts of the right brain are evolving in your neuro, the insula and the right amygdala, the center amygdala, and that's setting up.

And you also have synchronization across the placenta, whereby they are regulating each other's autonomic nervous systems. Can adrenaline pass across the placenta? I should know this. I know adrenaline doesn't cross the blood brain barrier, but the brain makes its own adrenaline.

But do we know if adrenaline crosses the placental burst? Most of the studies have been on cortisol and high levels of cortisol. They're on a cortisol. So if you have, let's say, the amygdala, which is in a critical period of growth, the right amygdala and the cortisol levels are very high, that's really going to not be an optimal situation for that amygdala to evolve because you're going to have a continual stress response there.

And that's what I have. And essentially what that means also, that if the mother is in a very stress state during a utero, some of that literally now is going to impact the lower areas of the brain. So as far as adrenaline goes, I'm not sure on that. I don't see why not.

Although hormones certainly cross. You know, we're looking at not only changes in neuromodulators. Especially, incidentally, the key here that we're trying to regulate are the neuromodulators, excuse me, dopamine, reward, noradrenaline, adrenaline. It's those which also, early in life, literally form plastic neuroplastic so they will form surfaces.

That's what we're attempting to regulate here, to down regulate very high levels of noradrenaline and upregulate, you know, dopamine, et cetera, et cetera. I'd like to take a quick break and thank one of our sponsors, function. I recently became a Function member after searching for the most comprehensive approach to lab testing. While I've long been a fan of blood testing, I really want to find a more in depth program for analyzing blood, urine and saliva to get a full picture of my heart health, my hormone status, my immune system regulation, my metabolic function, my vitamin and mineral status, and other critical areas of my overall health and vitality.

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Again, that's functionhealth.com Huberman get early access to function. As I recall in your book Right Brain Psychotherapy, there was a description, beautiful description of, you know, these up states and then these more calming state coordination between mother and child. And I started to. I actually read this book when I was living in Topanga.

I walk on the road. I don't recommend this. There are no sidewalks in Topanga. I would read the physical copy and I recall very distinctly thinking about this image of the baby and the mother.

And, you know, the baby is a little bit, you know, hyper arousalis is upset. And so the mother would make, you know, sort of sounds, not necessarily words like these kinds of things or humming or, you know, lullabies, these sorts of things. The prosody. The prosody and then the related release of things like serotonin, perhaps oxytocin as well.

We talk more about those. But then also how critical it is for the mother to be able to regulate the baby's transition to up states. Like looking at the baby that comes out of a nap and saying good, you know, good morning and really wide eyes, lots of gesturing, lots of gesticulating, that is, you know, bringing the voice level up and the baby, you know, really waking up in a kind of a steeper slope of arousal and how important that was and that being slightly more related. And this makes perfect sense to norepinephrine adrenaline at low healthy levels and perhaps dopamine as well.

Is that the right way to think about this? And if so, is that what's going on? When we form adult friendships, adult relationships, are we oscillating back and forth between the ability to hang out and relax and soothe each other and the ability to kind of get excited about something? Is this the basis of all relationships and relating to.

Yes, yes. The key here is emotional regulation. Again and again, it's implicit emotional regulation. One of the tenets, central tenets of my ideas here is that first of all, there has been too much of an emphasis on the down regulation of negative states.

Remember the original attachment theory of the secure base? That baby would come back in a stress state, she would down regulate the negative states. But really attachment is about the down regulation of negative states and the upregulation of positive states. Still, at this point in time, the importance of positive states in the human experience are overlooked.

Positive emotions, joy, enthusiasm, excitement, positive states literally are the key. And there are hormonal aspects to that, as you just point out, for example, dopamine, etc. Etc and this goes for therapy also. And therapy is not only just a down regulation and the sharing the down regulation, but it's also sharing the upregulation of positive states.

Because that's, you know, that's a critical piece of it also. But there still is that bias. Look one way now, in the Right Brain book, I'm also talking about two types of love, quiet love and excited love. This was the famous psychoanalyst Donald Winnicott, who was a pediatrician, who was one of the great psychoanalysts of the 20th century.

And he made the distinction between quiet love, which would again be the downregulation in the noradrenaline, and excited, which is into a parasympathetic state. So you're going from a hypersympathetic state into a parasympathetic state, quiet love, and then excited love, which would be also passionate love, which is the high arousal state out of it, so to speak. And they are both important and ultimately they both need to be integrated. And you may have a situation whereby one can do one, but ultimately they have to come together.

Let me make this important point. In the end, we have negative emotions for adaptive reasons. It's there, let's say shame. Shame is meant to dose down very high levels of arousal.

And if one can't do that, very high levels of arousal. Let's say in narcissistic personality disorders, you need to be able to. So we need to have access to both positive and negative emotion. But the real key to a secure attachment is the ability to integrate both positive and negative emotions.

So with a really good serial security attachment, mother, when that baby is in a down state, literally, she can literally ride down with that baby and synchronize. And when it's enough stage, she can really ride up with that state. In the case of narcissistic personality disorders, let's say, for example, I'm jumping here, we've got an insecure attachment. It can be an avoidant attachment or the other one.

Depends what kind. There are two different kinds of narcissistic personality disorders. You can have anxiously attached two different types of narcissistic personality disorders, a vulnerable attachment and egotistical attachment. You said a vulnerable attachment.

Vulnerable attachment is an anxious attachment. These people constantly need praise. Yeah. Yes, but also egotistical attachment.

But my point out of that, essentially here is the stressors in life are there and that the negative stresses are there, but we can learn from those negative stresses also, etc. And ultimately what we need to do is to Be able to know how to integrate. If we can't integrate the positive and the negative, we'll end up with splitting. You know the term?

Because I believe that's a primary feature of borderline personality disorder, which I think we should also touch on. Yeah. So my understanding about splitting is that it's the I love you, I hate you phenomenon brought on by not just an internal switch, which is sometimes seen in like bipolar disorder, but rather somebody with a borderline personality disorder will see something like. And be like, very upset.

Like suddenly, like the fact that a glass is empty a drink meant that they didn't think enough to. To like, refill a glass or something. Whereas a few minutes before it was perfectly fine. It was not an issue right there.

There needs to be a trigger. And then they split. Is that right? Yeah, yeah.

So essentially, you know, the splitting. Usually the splitting goes out. Externally, that person is all bad. I'm all good.

So now you have that splitting. It's there. You can't see anything of a goodness in that person at this point in time. Does this sound the other way?

That person's all good also be that all good, but also have internally splitting. You have an internal split between a good self and a bad self. And internally there's an internal object relation that we all have as we internalize these external relationships. So that there's a good self and a bad self, literally.

And that they cannot be integrated, so to speak. And that that part of me, I hate that part of me versus I love that part of me also. In terms of borderline, usually what you see at the very beginning is that there's an over idealization of the positive values of that therapist. And then there's some.

There are some then stressors and misattunements and ruptures that aren't repair. And now all of a sudden, what was totally good now becomes totally bad. Incidentally, that could be, if there was not a strong therapeutic alliance, the point at which the person will drop out. Are these people with borderline personality.

I don't know if you still call it a disorder nowadays that gets a little bit into the. Let's call it borderline. With borderline, do they exhibit the same sort of splitting idealization, and then the idea that somebody is terrible and they want nothing to do with them. In the context of work, relationships, friendships, does it extend out into other domains of life or is it unique to certain types of relationships?

I think it's a way of seeing the world, remember? And the way of seeing the world essentially is Very different from the left hemisphere and the right hemisphere. The right hemisphere sees the world through emotional relationships and that. So that can become a trait that can be really hard and fast trait.

Let me put it another way. In the case of narcissistic personality disorder, the baby is all good. The caregiver, primary caregiver is always thinking very positive about that, about that infant. But when that infant now all of a sudden becomes depressed, the interactive regulation stops.

At that point in time, the caregiver doesn't want anything to do with it. So at that point in time, now everything is unconscious. If you and I are together and there is a misattuning between us, what possibility, let's say the dismissive attachment is all of a sudden I will disengage, we got too close. And at that point in time, maybe I'm acting out my early attachment dynamics because what the baby is doing is expecting what the mother will do next.

And at that point in time there's a misattunement like that. And so in the case of a dismissive personality, that person will emotionally disengage, okay, Become very abstract at that point in time. And at that point in time, I can't feel you. I hear what you're saying.

And so at all points in time you have this situation of coming closer and moving apart, coming closer and moving apart. And this will be acted out in the therapeutic relationship also. And, and so that every time the person is. The anxious person is stressed, they'll come in closer to you now, now they're more demanding about what they need from you.

Look at the tone of my voice while the insert you're avoiding now is now going to deactivate it. And at that point in time, my voice will now get flat. You can't even hear the effective tone of my voice. So I'm telling you that we always pick up at the level of our own physiology how emotionally close or distant that person is at this point in time.

Especially at points of stress, whether I'm coming in or I'm moving out. Let me go back to this. All of this is occurring at an implicit level, which is why you said something about reparenting, etc. Too much is on a conscious level there.

If you really want to make these changes in a personality, they have to be changes in the right brain. And that's why all therapy now is looking into emotion. All therapy, no matter what the form of therapy, it's laying on top of the therapeutic relationship and emotion per se. I'm pausing because I'M just taking all this in and thinking about what are the ways that people can start to tap into this right brain health or lack of health and ways to repair their right brain circuitry, so to speak, without a therapist?

Or is that just simply impossible? No, it's not possible. No, it's not possible. We, we all do grow and understandably our right brains do grow.

But again, the key here, I'm suggesting the whole idea about interpersonal neurobiology was the editor of the Northern Syria Interpersonal, which is a two person situation. There has been too much of an emphasis on autoregulation and not enough emphasis on interactive regulation. The real key to changing the right brain is finding people you can be close with finding people you can be open with finding people you can be vulnerable with. That literally you can show your shortcomings and opening yourself up to those people as they open up to you.

It's literally to form that right brain to right brain communication system with someone else. I think I just got it. I think if I'm not mistaken, what you're describing is interactive dynamics that create or elaborate on circuitry that exists in all of us, but that for some people might be atrophied because of the lack of proper nourishment, emotional nourishment early in life. But that we can engage these circuits, these right brain circuits.

But then when we're not around these people, there must be something about the right brain circuitry that provides a sort of a soothing function. So that we must know at an implicit level that we can do this. Like we know how to attach in healthy ways to people. We have a close friend we can rely on.

We have maybe friends, plural. We maybe repair a relationship with a sibling, this kind of thing. So it's not that these circuits need to constantly be engaged every moment with a barista, with the. But somehow at an unconscious level, it must be that we come to realize that this circuitry has re.

Elaborated or has elaborated in a way that we know we can do it. You know, remember, part of the problem is being able to take in, to take these things in here. But the key to emotion. Incidentally, let me throw out important, another important term in terms of therapy situation.

I said essentially therapy is about literally reworking emotion. And the most. The key to mental health and physical health is also a right brain, a right brain emotional situation Here. The key here is that there are heightened affective moments in a therapy session.

I'm gonna go therapy then. I'll come back to your question. We've now formed the therapeutic Alliance. The stronger the therapeutic alliance is between us, more empathy between us, so to speak, the more we can share.

I'm now going to start to drop some of my defenses because the defenses are there to block affect, negative affect, and begin not to take a chance now to open myself up, you know, to somebody else's. But in a therapy session, somewhere around the middle of that session, the person comes in out of the world in a left brain state. Somewhere in the middle of the session they start moving into affect. And now the person is starting to talk in a more affective level and now talking about a memory or some sad situation or something that just happened in a relationship with a couple now even start hearing my voices.

Now the voice tone change. And these moments, which only may last, believe it or not, 50, 60 seconds, are heightened affective moments. These are moments when all of a sudden we are both in the right and we are both synchronized and the affective now is out there, so to speak. And that's the possibility now to get this change in these height and affected moments.

So to be in an interpersonal relationship with someone and to co create with that person a heightened affected moment in both of us which we are sharing at that point in time by taking the risk to the open at that point in time. Also these are the moments in life that you really go into your autobiographical memory. I remember my occasion with that person. I can bring back the whole context because remember, the right brain acts with images, images.

So I can bring back that image now and I can remember the closeness that I felt at that point in time, etc. These are putting into bright brain. So we are always putting into our autobiographical memory these heightened affective moments. So to have those shared affective moments with other people, these are really whereby you're making changes in the right.

And these are much more important I want to suggest than you know, intellectually. Now there have been certain fmri. I'm now going to. I'm going to move into a little bit of a different place here.

What I'm suggesting is that these right brain to right brain communications are always going on, but certain people literally can't read them as well as other people can. And they can't read the face of voice and they can't synchronize. Well, can I stop you ask one question which is let's say that, let's take this conversation for instance. I'm listening to your words very carefully.

If I make an effort to listen especially carefully to what somebody is saying, the Content of their words. Is there a competition between left and right brain such that I'm now not getting as much right brain listening? Yeah. Okay.

This to me feels like the surrender aspect. Whereas I can and I do this during these interviews slash discussions where I'll sit back sometimes and I'm still listening, but I widen my gaze. I don't look around, but I widen my gaze and I'm trying to just feel something coming in. I'm not a therapist, obviously no one would ever suspect that I was.

But I only do it for a few seconds and then I re engage. And I used to think that it was like a relaxation of sorts. But inevitably I feel like it's a different way to the conversation takes a different direction. Is that more or less what you're talking about?

Yeah, that's a colossal shift, understandably. The corpus glow, you can shift from the left and to the right about 100 milliseconds. So essentially you can't be. You have to be in one hemisphere or the other.

So if I'm listening very carefully to like exactly what you said and I'm tracking everything said, like I'm gonna, like we're in a courtroom situation, Then my right brain is suppressed. Is that right? Good feet, good feet. Now watch where I go here.

Okay. The right hemisphere is dominant for attention. Okay. I mean this baby and this mother, literally she's focusing our attention on that baby's face.

Don't voice. But there are two different types of attention. Strong neuros neuroscience to show this. The left brain operates by narrow attention, narrowly focused attention.

As the best example of narrowly focused attention is. You are following my words one after the other. But there's another type of attention which is used by the right brain, which is called wide ranging attention, which comes right out of Freud, which he also called, maybe you'll remember this evenly suspended attention. I haven't heard that.

That's beautiful. It's the same thing which is much wider than that. And that form of attention is the form of attention that the right brain has. Because the attention at that point in time is not only of what's coming from the outside, but also attention to what's happening in the inside.

My own inside. The changes in my own physiology at that point in time also. So yes, there are these two different forms of attention. And essentially the only way someone who was just narrow all the time, a personality who just lives in the left hemisphere.

A hyperlinear person. Exactly. Hyperlogical, hyper rational. Cannot really see the big picture.

But literally that kind of situation. So essentially that kind of person is always looking at the narrow aspects and cannot see the broader context. The broader context. Because there's a context that's being set up right now between you and I, there's also a context that's being set up.

And that context also has to it a kind of a feeling of safety and trust as we literally just go off wherever our, you know, our thoughts are with some idea that literally you'll be able to follow that you'll come back with me at the same time. So the context, the emotional atmosphere between us changes when you go left into the right. Like that point here is that it used to be thought that you, the only way you could understand the brain was by looking more intrapsychically into one brain. If you understood how one brain worked and everything was interpsychic.

But then there's the interpersonal part of it. And so essentially what we're moving now from a one person into psychic psychology to a two person interpersonal psychology. You see what I mean by two person? I got the mother here, I got the baby there, I got the patient here, I got the therapist there.

And between them literally are going back and forth at all periods of time, right brain to right brain communications underneath the conversation. So neuroimaging, hyperscanning, neuro imaging, if you're familiar with hyper scanning, another paradigm shifting thing that is occurring now, inner imaging for the first time. We can now scan two people, nirs, eeg, whatever you want, while they are in the middle of a basic interpersonal interaction, a memorable interaction between the two of them. These studies have now been done and what they did was that they found is that the two brains, especially when they are into emotional states and when they are looking at each other face to face and they're concentrating literally on how to empathically be with that person, etc emotions, so to speak, they find that the right brain of one will synchronize with the right brain of the other.

And the part of the right brain that synchronizes with the other is the right temporal parietal junction. A lot of evidence now on the right temporal parietal junction. I said right brain to right brain. So now the eyes are coming.

I remember the eyes are, I mean direct eye connection really is the most powerful form of communication. I always remind people these are two little bits of brain outside your cranial vault, as weird as that might seem. They're two bits of brain, your central nervous system. And you're looking at that's about as close as you can get to looking at somebody's brain state as anyone, the eyes are being controlled by the autonomic nervous system.

So you got, you have an autonomic nervous system to order nervous system synchrony here, so to speak. But, but essentially what's occurring at this point in time. Face, voice, gesture. The face is processed in the posterior parts of the right hemisphere.