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Dr. Allan Schore & Dr. Iain McGilchrist—with facilitator, Dr. Mary Meador

The following is an edited transcript, presenting selected highlights from a conversation between Dr. Allan Schore and Dr. Iain McGilchrist for the GAINS Living Journal webinar series. The full version can be viewed in the members area of www.mindgains.org. Dr. Mary Meador, board member at GAINS, facilitated the discussion and introduced the speakers.
Transcript reproduced with permission from the Global Association for Interpersonal Neurobiology Studies (GAINS)

Introductions
Mary: Welcome to this very special GAINS Living Journal presentation with Dr. Allan Schore and Dr. Iain McGilchrist. This webinar is titled “Considering the Nature of Our Left and Right Hemisphere’s Engagement.”

Some of us look to neurobiology to help us understand the science of what it means to be human, to appreciate how our experiences shape us and impact us, and in turn, shape the way we experience the world. That interaction with the world requires the right hemisphere’s broad attention, which is inclusive and opens us up to possibility. This activity is coupled with the left hemisphere’s narrow attention, which collapses the world into specificity and certainty.

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Dr. Allan Schore is on the clinical faculty of the Department of Psychiatry and Biobehavioral Sciences at UCLA David Geffen School of Medicine. He’s the author of four seminal volumes, most recently, The Science and the Art of Psychotherapy (Norton, 2012). Soon Norton will publish two more books: Right Brain Psychotherapy and The Development of the Unconscious Mind. Allan’s contributions appear in multiple disciplines: infant mental health, attachment theory, trauma studies, behavioral biology, and more. He’s the past editor of the Norton Series on Interpersonal Neurobiology. He’s won multiple awards, including an award for outstanding contributions to practice in trauma psychology.

Dr. Iain McGilchrist is a former Fellow of All Souls College, Oxford, a Fellow of the Royal College of Psychiatrists, a Fellow of the Royal Society of Arts, and former Consultant Psychiatrist and Clinical Director at Bethlem Royal Hospital in South London. He’s been a research fellow in neuroimaging at Johns Hopkins Hospital in Baltimore. He’s published original articles and research papers in a wide range of publications on topics of literature, philosophy, medicine, and psychiatry. He’s probably best known for his 2009 book, The Master and His Emissary: The Divided Brain and the Making of the Western World (Yale).

He’s currently working on a film entitled The Divided Brain, though we’re not sure of the exact release date; but a film by Bruce Parry, called Tawai: A Voice from the Forest, is a fabulous film that features a lot of work that Iain has done, and the concept of looking at the world from the right-brain perspective, and the necessity of doing that in terms of moving forward in our universe.

Iain is also currently writing a book entitled There Are No Things for Penguin Press. Iain joins us right now from his home in Scotland. Thank you for being here. Welcome Iain and Allan.

Iain: Thank you very much. I want to say what a pleasure it is to be talking to Allan, partly because he’s had an enormous influence on me. When I was working away in obscurity at the topic of hemisphere difference, he was a shining light of somebody who really had looked at this in some depth and was saying something different from the normal run of things in the world of pop psychology. He gave me heart that such intelligent things were being said and could be said. So, it’s great to be with you, Allan.

Allan: Let me just quickly say, before I give you a quick glimpse of where I’m going now: in 2009, a member of my Seattle study group brought me a book, which he had carried from London to Seattle to give to me. It was The Master and His Emissary. “You have to read this. The two of you literally are of similar minds here,” he said. And so that was the beginning of the conversation, as you’ve just alluded, that conversation that has taken place in Los Angeles . . . that has taken place in New York . . . that has taken place in London . . . and this is just another step along those conversations whereby we mutually enrich each other’s thinking.

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Re-enactments
Allan: In 2014, I presented the idea to the journal Psychotherapy, which is the division of psychotherapy of the American Psychological Association. I stated that the right brain is dominant in psychotherapy. There are, clearly, various forms of psychotherapy that are left-lateralized (CBT, etc.), but here I was making the argument that the right brain, which is dominant for the processing of social emotional information, and for stress responses, is dominant in this context.

Continuing forward, I talked about the early attachment relationship between the mother and the infant. Now I am talking more and more about the father and the infant, and how that would show up in emotional communications within the therapeutic alliance and occur at nonverbal levels beneath conscious awareness through expressions like prosody and gesture. But, at the heart of what really was expanding, were my ideas about clinical re-enactments. If there was early attachment trauma, then that would be re-enacted within the therapeutic alliance, beneath the words, especially among patients who had experienced early trauma and were seen as being refractory to psychotherapy. They could not be helped by the “talking cure” because interpretations were problematic with these patients. I was suggesting that in such cases, in personality disorder and borderline personality disorder, that they would re-enact the trauma.

The key was whether the empathic therapist would remain psychobiologically connected to the patient in order to pick up these unconscious communications beneath the words. To be able to pick them up at a bodily level, so to speak—an imagistic level—and then be able to take these communications, to regulate the communications, so that, instead of the old idea whereby the therapist would remain up left while the patient propped down right into the intense negative affect, literally they both would make the journey together down into the intensive right hemisphere affect.

This fits in very much with the strong emphasis these days on the relational trend in psychotherapy, and the move into two-person models. What I ended up with is that either the location of the trauma can lead to a compulsive repetition of the same problematic situations, or, if the therapist is creative at that point in time, and spontaneous, while remaining connected to the patient, they can regulate the state.

The key here is the idea about empathy, and that the therapist must be psychobiologically attuned to the internal sense of the patient—and again, beneath the words, what is resonating with those states, and is synchronizing with those states, so that they are in “synchronization”, which is the same term I use for what you see in mother-and-infant attachment.

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Attachment Roles
Iain: What I’m also interested in is that we play a role, and I know it’s not always an easy role, in helping people to realize how important parents are to their children in the early years of life. The sometimes uncomfortable thing to hear is that mothers are more important, but fathers have their role too, particularly in the second year of life.

These things are sometimes received as surprising pieces of information when I talk to people. I don’t know whether it’s the cognitive dissonance that they don’t want to hear that because their life is organized in such a way that they can’t accommodate it. But it seems odd to me that people are . . . that there’s resistance [to] this idea that a mother is fantastically important to creating the bond that makes a new individual life that is secure; and that a father helps to maintain that and set boundaries to it.

Allan: I had also put forth a hypothesis that just as the mother first is shaping that right brain, the father . . . starting into the second year, the left hemisphere goes into a growth spurt . . . the father is now helping shape that left hemisphere. So now we’re talking about two hemispheres, which are critical. The right, which is dominant for affiliation dynamics, and connectedness, and the left, which is involved in power dynamics and autonomy. You have the shaping forces coming from both of them on both of these hemispheres, so to speak. And ultimately what we’re looking for is somewhat of a balancing between these hemispheres and the ability to shift into each as they are needed.

In the second book, I think I sent you this article also, an article in the Infant Mental Health Journal entitled “All Our Sons: The Developmental Neurobiology and Neuroendocrinology of Boys at Risk”, where I look at the problem of why boys are at risk for conduct disorders, for ADHD . . .

Iain: I found it fascinating.

Allan: . . . for autism spectrum disorders, and for early schizophrenia. What I suggested there is integrating the endocrinology literature with the neuropsychology literature, to make the point that the reason why boys are at risk is because we are seeing differences in emotional and social development in boys. They are lagging behind girls, such that even in the foetus, the male foetus is maturing more slowly than the female foetus. In the first year, postnatal, girls are more socially active before boys are, etc. And I’m suggesting that the reason for that is in addition to environment and social differences, and in addition to hormonal differences, because essentially the male’s right brain matures at a slower rate than the female’s right brain.

Now if that is the case, it also means that the male right brain, early in development, it is more immature for longer periods of time. That means, therefore, that it is more susceptible to attachment stresses, as well as to endocrinological difficulties, endocrine disruptors, and environmental toxins.

Iain: Exactly.

Allan: Incidentally, on these masculine disorders, we’re now seeing a significant increase in these disorders than in the past. That’s the other side of the coin—this slower maturation rate.
Iain: I found all that very interesting when you sent that to me, and I hope you’ll expand on that work, because it seems to me it’s very, very important since it affects half the human race. I think it is connected to various environmental changes as well as some societal changes. So, very important I think.

Allan: Iain, where are you going now?

Iain: I’ve been looking at how the two hemispheres view truth, and what they would contribute to it. Not in terms of one offering reason and the other offering emotion or anything like that, because, as you know, that’s not how the hemispheres divide . . . but what aspects of reason, what aspects of intuition, what aspects of imagination, what aspects of our sense of embodiedness, offer to our ability to discriminate between things that are helpful and meaningful and more truthful.

And so, in looking at that, I began to realize that the world offered to us by the right hemisphere—what it is aware of—is very much a representation of the world in its own terms. It is, as I’m constantly saying, a hermetic world, a hall of mirrors, in which it has a system of how things work according to internal rules. The right hemisphere is less willing, literally, to forego that—to question it, to deny it, or to accept that things might be otherwise.

I’m not just saying that in some metaphoric way. There’s beautiful research that shows that this is the case. If we are to reach a more sophisticated understanding of the world, of ourselves, of what a human life is, of what society is, and of how we relate to this planet that we’re in the process of rapidly destroying, we need to “re-sophisticate” our thinking, and not listen to the simple stories, the simple and easily expounded stories that are just purely rationalistic ones.

The difficult trick is to make sure that people don’t think that I decry reason in any way. If we lose hold of reason, then we’re completely stuck. We need reason very badly, but we need sophisticated reason, not just the kind of logic processing that a computer would be capable of.

So, it’s getting back to an old concept of reason, which I think we’ve lost, rather than purely rationality, which incorporates the best that we have from experience (which will always be very difficult to articulate) and is expressed through the narratives, the myths, the art, the drama, the poetry, the music, and indeed the best of the philosophy that we have developed over two-and-a-half thousand years of civilization in the West, and what we can gain from an even longer story in the East.

I’m trying to synthesize these things in some sort of a way in order to create a little guide as to how we navigate. I think a lot of people nowadays feel they’ve lost their bearings altogether. They don’t know what to trust. People tell me there is no truth. Other people speak very loudly that they’ve got the truth, but it sounds terribly simplistic to me. I’m afraid that I don’t know how to argue against them.

I hope that when people have finished plowing their way through whatever it is I’ve finally finished that they will feel strengthened in their feeling that there was something more to this. If you like, I’m taking a blast against the worst kind of reductionism in which everything is made to consist of the simplest elements that we can find. I’m much more interested in how we understand the whole, and how we understand the parts from the part they play in the whole, than I am from understanding the parts, as though somehow in themselves they could be understood outside of any context.

Allan: So how do you feel about the balance eight years after writing your book? How are we standing in terms of the imbalance of the left and the right? Have you seen any progress in that area?

Iain: I’ve seen two things happening, really. I suppose they are mirror images of one another and they’re what you’d expect. One is that in the process that I describe, we get more and more sucked into a certain, almost algorithmic way of, a mechanistic way of thinking. The second is that just because of its enormous destructiveness, and because of its barrenness, I think that everybody realizes and feels and experiences, that there is now a move afoot to seek something else.

For example, one of the things I wanted to talk about very much was the role of science, because I believe profoundly in science. I couldn’t write what I’m writing without having spent decades puzzling over the science. Yet, there are some things about science that are troubling. For example, physics gave up believing in a machine model of the universe over 100 years ago. Curiously enough, the kind of loud voices in the world of evolutionary biology tend to talk very much in terms of machines, computers, robots, and so forth. I find that fascinating, but I also discovered that there is a strong movement afoot, very interesting work, in what’s called “process biology”. I’m very interested in process philosophy, which is what lies behind my new book title “There Are No Things”.

I had a conversation with Jordan Peterson impromptu online a month or two ago, and I said I’m going to write a book or I am writing a book called “There Are No Things”. He said, “Oh, so what are there?”

The answer is there are patterns and relationships, and above all, there are processes, flows. Nothing is static. Nothing is single. Everything is connected and changing.
So, it’s these patterns out of which the bits that we can identify stand forth in the grasp of our left hemisphere, which, as you know, focuses on the things that stand out from the background, without perceiving the background that makes sense.

It’s those that we call “things”. And then we think back to front. The world is made of things, and I need to put them together. Whereas physics tells us the world is not made of things, it’s made of relationships and patterns, and it doesn’t need putting together, thank you very much, because it already is.

Early Intervention: A World View
Allan: You and I met in the British Parliament to talk about early intervention and early prevention of psychiatric disorders. I suggest that we’re now in a position where we can come up with psychobiological models of early developing, which are optimal or less-than-optimal. I think we have the tools for this kind of situation. Whether or not governments are going to be able to support the economics of this kind of situation is another story. But really the next goals are on a much broader cultural scale.

We’re talking about the mental health of community and cultures. And for me, the key to that is optimizing early developing: prenatal and postnatal developing.

Iain: I think you’re right, but what would you say to my view that what’s absolutely ultimately essential is that we—it’s not just that we’re coming to the point where we need to give people the therapy, but changing . . .? I don’t know how to do this except expressing my own ideas, and I hope you people will espouse them, and that’s all any one person can do, or you can do too.

But we need to change the way in which we live. We need to change our societies, because it’s making people sick. It’s deeply pathological. When you think about the things that we’re doing to one another, to the world, and so on, it’s a species of madness. It is literally a kind of madness because it is driving people into mental illness.
It’s a little bit like trying to treat people’s lung cancer by whipping out lungs and giving them iron lungs, when what you really need to do is stop them smoking. In the world of psychiatry, I feel it’s that way around—that we’re in the business of destroying ourselves as human beings. We’re turning ourselves into something almost unrecognizable by people in the past, and sadly lacking in many of the things that make for a fully functioning and fulfilled human life.

Those come from community, from society, from ways of engaging with the world from which it seems to be we’re now deracinated. I think that’s at the root . . . deracinated, but it’s at the root of our problems here.

Here too, world-wide, we’re agreed on this.

Coming into the picture much more strongly these days is epigenetics, and that’s been very good for “sophisticating” the conversation about nature versus nurture. Now we know that things that happen during one person’s lifetime can indeed alter genetic expression in such a way that the offspring seem to be sensitized by things that were experienced by a parent, not necessarily at the time even of their conception, sorry, not during the process of gestation, but prior to that. So, it is remarkable stuff.

Allan: I think more and more we’re going to see a shift away from the cortical levels into the subcortical levels, into the reticular activating system, etc., because in the first year of life, the subcortical structures of the brain are increasing 110%. There is too much focus on high executive function. I think these lower ones, autism spectrum disorder, amygdala problems in autism spectrum disorder, are more and more shifting down into these earlier mechanisms (HPA mechanisms), which are enduring, which are really associated with susceptibilities and vulnerabilities and later problems.

Iain: One of the things that amuses me about the history of psychotherapy is that there was a time when people thought of the conscious mind as taking up most of the picture, and the unconscious as just this slightly odd dark area in the basement somewhere.

Of course, now we know that what we’re conscious of—it’s obvious, really—is just a tiny fraction of one percent of everything that’s going on that we’re aware of in our bodies at some level, and that is being processed. And so the question is: what the dickens is this little bit of consciousness we’re using doing here? Because it’s probably not influencing an awful lot.

Last Words
Iain: One thing I’m trying to do in my book is to reverse the idea that somehow the right hemisphere is a sort of . . . you know that neither you nor I believe this, but somehow second best to the left hemisphere. I’m suggesting that in all kinds of ways, in its ability to perceive things, in its ability to understand them, in its ability to attend to things, in its ability to engage with them, it is actually superior to the left hemisphere, which is able to process certain things. It’s very good at following procedures, but understanding why it’s following them, what those procedures mean, it’s not so good at. The right hemisphere offers that.

The right hemisphere is in that way, as I’ve believed for many, many years, foundational to our experience, as well as capping it off at the top. It both grounds what it is that we experience and makes sense of it as a whole at the top end.

Allan: This gets back to what I was talking about before, these regressions in the service of the ego that I would say are regressions in the service of the self. Where literally it can regulate its own state for the purposes of its own growth and development. This taking off of the higher and letting go, so to speak, of the lower; which, I think, is essential to psychotherapy. For human beings to live a deeper and richer life, we need to understand how to utilize this capacity to be able to let go of the certainty of the left and lean into the ambiguity and the richness of the right.

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