developing right brain

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1 I Chapter 2 influences: The ;9:99G'1000. {. & Simnff, iew f research P. & Bailey, A. rirical findings.,rplay and psy- Psychlgy and Ref atinal traum a and the develping right brain The neurbilgy f brken attachment bnds Alln N. Schre s l cgnitin: 328. and individual (1996) Attachrst year f life.,n: Oxfrd Uniin securely and 'ic cnditins in attachment. In tnships (Vl. 5, ks. r f separatin- Psychiatry, 133'. g n attachment rsiveness amng 457-t477. vi.j. (1999) Disrsrs, cncmi- In J. Cassidy & clinical applicatn, G.G. et al r. rsick, R. (2008) r Cummings. c acids. Nature, Over the past tw decades I have integrated nging sc clinical data in rder t cnstruct regulatin thery, a ne mdel f the develpment, psychpathgenesis, and treatm self. Twards that end, in 2001 I edited an issue f the Inf Jurnal, and in it I ffered an article, 'The effects f early n right brain develpment, affect regulatin, and infant this chapter I build n that wrk and prvide very rece develpmental data that allw fr a deeper understandi lgical and bilgical effects f early relatinal trauma. will be n current studies f the early develping right br substrate f the human uncnscius and the site f the subcrtical regulatry centers. This interpersnal neur explicates the mechanisms by which attachment trauma the develpmental trajectry f the right brain/mind/bd curse f the lifespan. Als discussed is the etilgy f pa atin, the bttmline defense f all early-frming sev psychpathlgies. Pierre Janet (1889) defined pathlgica phbia f memries, expressed as excessive r inap respnses t thught r memries f 'ld traumas'. It is n 'ld traumas' specifically refer nt just t childhd tra relatinal trauma ccurring in infancy, the critical perid theretical perspective has direct clinical applicatins f treatment and preventin. Develpmental interpersnal neurbilgy secure attachment The essential task f the first year f human life is the c attachment bnd f emtinal cmmunicatin and inte between the infant and primary caregiver. There is nw agr ing hw t cmmunicate represents perhaps the mst im mental prcess t take place during infancy' (Papusek &

2 cnsciusly interactively regulated... has shi regulatin thery. Secure attachment depends nt n the mther's ps with the infant's cgnitin r behaviq but rathe infant's internal states f arusal, the energetic affective state. Thrugh nnverbal visual-facial, tac prsdic cmmunicatin, the caregiver and infan ture f the ther and mdify their behavir t fit creating a specifically fitted interactin. During cmmunicatins f mutual gaze, the attuned mth tempral patterning f her exgenus sensry st spntaneus expressins f endgenus rganism gent respnsivity, the mther appraises the nn infant's internal arusal and affective states, regu cates them back t the infant. T accmplish must successfully mdulate nnptimal high r stimulatin that wuld induce supra-heightened arusal in the infant. In rder t enter int this cmmunicatin, the m lgically attuned t the dynamic crescends and d bdily based internal states f autnmic nervu arusal. Indeed, the intersubjective dialgue betwe sist f signals prduced by the autnmic, inv bth parties. The attachment relatinship mediate emtin, wherein the mther c-regulates the infa ANS, and thereby its internal hmestatic state. A nervus system (frm the Latin vegetare, t anim respnsible fr the generatin f what Stern (1985 Research nw clearly demnstrates that the prim attuned and ptimally mirrring, that there are attunement in the dyad, ruptures f the attachm f attachment transactins leads t a regulatr autnmic hmestasis. In this pattern f in dyadic misattunement (Trnick, 1989) r 'disrup Lachmann, 1994), the 'gd-enugh' caregiver, wh

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4 human infants'. ln subsequent neurpsychlgical lateralizatin in the secnd year flife, Schuetze and ;Attt ugt the infant brain was histrically reprted terms f cerebral lateralisatin until 2 years i ug., ev ln]ilutmg that lateralised functins are present much They fuiher bserve.lateralisatin i negative em,tr" ilgft, hemisphere in infants as yung as 12 mnt pmental enhancement f right hemisphere cntr.ipi.rrln that is evident by 2? mnth'i' Mtt recen (zl:tl2)cnclude,'earliermaturatinftherighthe by bth anatmical and imaging evidence'' - In my nging wrk I "-nlinu. t ffer data attachment mechinism is embedded in infant-care t-right-hemisphere affective transactins, and that bilgical mdel is supprted by a large!"91. :,.r.ui.r, (Schre, piq,'i,2003b, in press). with attachment cmmunicatins, it is nw establishe iin..upu.ity t efficiently prcess infrmatin fr input t the right (and nt ieit; tremisptrere <luring 2003). Develpmental neurscience dcuments tha the nset f a critical perid during which synaptic ping ccipital crtex are mdified by visual exp zbooi, infunts shw right hemispheric attivatin wh face'ltrrrri-mazyeretal',2002)'recentnear i.r.ur.n (perhaps the mst suitable f all neurscien thumaninfants)revealsthatspecificallythefive-m,prr.i. respnds t images f adult female- faces (Na et al.,2007). Clsertaninterpersnalface-t-faceperspect graphy GEG) study by Grssmann et al' (2007) ia intuni, presented wiih i-ug.t f a female face g enhanced gu*-u electrical actlvity ver right prefr cnclude ihat the brain mechanisms underlying ey tigt a"g."e f specializatin early in ntgeny, re n.l-irpi"r.. ther researchers have established th face-picessing areas fthe right hemisphere (Pelp In terms f tactile-gestural-attach-"nt "**unic

5 Ncyrb,lsr :1.,:1.11."'-t LC is 1 ri t: ri 1t r1 i^ lt I r1 ii d )- )1 ii Ii ri j- )-.) i.l rt ]S 7) <ici,-ilstlnics 'iutcliiiizcci systcm tl nclliiril imitatil' tltlcl ctrclitrle-:^ " u'arli,udvitutagc i'1itc lir:lil itctt-risithci* (Cilil'rl et al : Schlc^ 2 'lig'altitcn, 20t)1) iu iitc 1ir':;t f-cii'nrntirs i 1ilc rrra;'ali'cct thc llrtct'itii ailll.aluitcc f'tirc 1lt'si intilatirc gestllr';s". Sicraizlii ancl Wi! (i996) clcsc iiic cilccts f- tticit n tirc cil'eiti1.rit.rl,. t'ight heruisilltcrc. atrcl asselt thltt cl.rtinal iit'rpucl cli ittuch is r,-rr'rlc direct auti irnrnediatc if-itr.l. itlian u-1ci t6 titc lcli sirlc iiire bciy. Siuciic: i.lls (ir''mnsilatc titat sllllilillc 1:cs'Lnr'.'s lhai cx1'ri css lcciing sitil,cs cinnilrniclttccl rvititirt it Ci'itci ltc'.i ligii'. hcrnisithcrie sir''.tcii-trcs (Galllli:her' & I'r'ith. 2004). And tl.tii't'i ilci l'csculciicls 1t$'cniclrcl 1.hat cl:i,cliringi chikil'cn i'ci1, tt a 'rigitt hcn'risph rnii'iiilt!: rncclianislir intcl'1'acir.rg rvittr tirc irubic sysicm iltai l.lt'ce:srrr.rcaninl: 1'bsclvcci i ir,tiiaicd ctntin^ (Dllpi ctl ;t al (r). As tt' ai-lciitly ltisclic atiaclurrciri cinr.i.rr-ll.ticrttin:. i-lt'sciic l"lt'e i;!: ilt thlcc-r.iin"rir-ici iniari: activuics tirc rigiti tctitnt'<t1t:lt'ietiii l'c (llntac ci ai." 2006). ;\t ii ntn'lirs lhc vicc i'u rvtiriut's chilci-c1ir'-c :,1'rclch (i.t. rviiii smui'liut cra-r1:ciatcci ul'sciei1,) clicits a iight-iatelitli cvcl.rt-r'cirtcr.i plci'rtial (t:[{p) ( i'iriclri'c'. r11..?-003). Acclciing i l}t,'!:1c1 ailci ):lalic'a (2(X)l: 353): ihc ligiri ireitrisircre f'tirc ncrutc is activcl)'invivccl in i1-,c t.t.'r'cc1 1' sl'rcccil mclci;' ilild thc itlttriliitls 1' tit,.- viccs t' lrlilcl' s'.tlriltciiur,l ltc1t1i:. i-irc lrrc-spcech siitgc l'chi1d clcvelptt.tct'li is c itcielizeci by ilicl'uctir.rs <tf titc clescl'iptir,e zrtirl cn.ttiltai ctrtl.rt cii-ic nt1iit11' t iurtchanisrls lrcillr.lilg rvitirin litc iicnispitct'cs l pli ncipic i- t.tu-" citril l crutt-ttt tiicai i il..anri tll ihc lircl siclc t'thc uttachll'iclt clyitti. tcscilicitcrs nii' cicsciibc mtircr"s i.lir.rccssing capacitics: '.2\ nrurbct' i' litnciiits lcaiccl r-;itltii ri1:iri hcir.lisliiclc n'il' tgciircl-l llii tr.rtlitrirlg i- ll blibl'. As *,'.: ct-ittin a;rci lircc i-l'c;-.sing lire iighl iicilisnhclc ts alstt sttcciaiizc itilciitif itclccl.riictit. thc l;r'ccptin i ii.tttt.liin. ;.1'.',ctirirttr" liticl ill inlirnraiiri' (Ilunic &'lbcici"?.(\(\4: ),?, 23). -Ihis iighi iatcraiizcci s)'s1clu strcs a r'cilbtiiary l'trtrvctbal ai]'c tirciul r.ritlrssii.rs. LrcstLlrcs. arci plscly^ r'ight braiir siltnliis ttscri in lrll lltuchutcl.rt ct>rnl.r.rlinicutins (scc Schrc's inclel l'aficct r-cgt-iilttiri iig[t blairr clcr'clprnent iir Iiiiric 2.1). 'firc Lltput 1'tirc ligitl irctt.iisd 'lilc ciittiltitl i>t'ltil.r^. is a cttscitrs aliect.'l'hc highcsi ccilicls f licr"irisplicrc. csltcciaill' tirc l'bitlliriui (r'cn'tt'urcclial) crte\" iitc lct llri'ib1,^: allaciuitcill sysil-n.]" act as thr-.'['iiiil"s li. si ctnplcr. ailcct atrel s lcgriiatr'1' sysictil (Schr';, i99,i a. 2(X)3b; Sr,riijvau & Glaitn. 2 'Iilc i'gut:izatiil i'ricuriiitic aircl syiriiptic tcint"i.s iir tltc rbiilt' (1nc1 ui-ricl'il cir:llliluic) ciicx^ iuciticling iis cirneciiirs iltt liic iim s)'stcil. illc Llt'.ls dllniaticlilly,.;hl:pcei b1' earl1, t'cllttiltitl clncrtirli:i L'\pjl (Schi'c. 199,j: Ilel' ct ii1..2()03).

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9 L -t v x ; < -) -:, =-'a -=;.1 X 5:; i-i : m -: ii ;:ni3x=5': 6^= cfq;-;d) sil9. Y, ij y X ri x i, :. Y. i.-r:i- "'.. ic F t; :: eafl+i=ebi 3id[:ls*F,:t 2ta!3Ef ;"; Bnai'E';;S 3t '.e,;i -^lt =.+ 3;li:!i ;'86I'i Y(rvf,.--.ld:"re Y?.12d:j.( ^ -p- :r-i) ef+fr? ;tt)::v 7n;A'';5*;3 =: J.i -^'i-r ". - '; e:j is:16 'di-:t l, ','.,.'..+H69., qe ;iuf.,r i9xql K3;Q :: f,: S rl +i ;{:-<.: )j 5 l/= -.: X ll Y ',; ii,? '': ld:- c?)! ; \- Y-b fl i! 5 g 7. &.i 'i p - t-tc ) =- i l -IC nir. c -n Y:'.eY=:= -d'li-' v-]x - ;A':Q, -: a.' "_*r:ani;-ct:ei)t, ^' :! = O i^ ;': O Oc :- - 3;q;2:*. t-7::- r:r): x.r't:;(.-...,.i E I g'.;';-\-3 gs'j':9":-l i,a" :: I t a a 2!??*!.:;; j-()c' G;t1 x a "..1- i - q t;. tjl -.l ;-,,1 i:. r: r'; n{ii2;i-in'f <a }:t?t e;ag 9.=-?{. :. #i 7,'=.-.i af L'rtii iti: 4:St9 3tl i._l;- :.:7,_.-i. 2 ;- p : "''. Y, a ta '- '-l- tr d i.!- ii i"f lrl+: l!: i r,' ' :'=';.X.a ;'-:n =iti b-i.:li ; - i;=".i'ii ::),i ; ;- L 1b :- 2 3t: X in-; 'J d 1 l?'9 rj Y ir ;., ' (;! i. = I iur:a 1.ii ii+ ;3,--5 i rl 1;a l. 3 ': U n-- 3;;-= O =.4:.: i-i ^..3. 4! ".) ^ - 6 qi ir. A c.,'!, ; l.:,j. 9 ;-l Z,') i..ir*; c b. i-l_,,. i.i. a: -' ;:.: H { ;r l.:'5? :: i;',"x+' =lc -; 9 j:"^i - aa i*i'< f9.3..i&nr Y. 124 : :5.i.i:i;r-i. -::id.::,il-qr b,;3;f d':2 i ':]aelr;di < --l! ^..1 I r L 6 --! O 5d nl,j 7 ii7 7"i J::-^i1r',:.a ii s: 9i 'br c :J T-e!: d ;r a v t ^ =,;i4 iirl: ; i -al;9- '- ^ x:j\ s?.- ọ: 3 :r C.l

10 cncludes, 'ur results are in ag addressed the imprtance f the ri (Minagawa-Kawai et al., 2009: 289 At the end f the first yeaq rig implicit-prcedural memry, an which encdes strategies f affect individual thrugh interpersnal uncnscius 'prcedural expectati during stress (crtina & Litti. 20 experienced as left-brain cnsciu enced as subjective right-brain a ('gut feelings'). At all pints f are expressed nt in lcft-brain sec prcess cgnitins (Drpat,2001; S Attachment neurbilgy ptimal attachment cmmunicati central nervus system (cns) lim scial emtinal stimuli and the generates the smatic aspects f e grwth-faciliterting emtinal envir an internal system that can adap psychbilgical states (and therc gd-enugh mther ffers her se a separatin; she tends 1 respn emtinal expressins. She als a generated during c-shared play sta expansin lthe chiid's right-brain the develpmental principle that s against trauma-induced psychpath In cntrast t caregivers wh f neglectful caregiver nt nly plays affect in the child. Such caregivers envirnmental impingements, includ f relatinal trauma this carcgiv

11 iniiltl.lt'ct1.l'iuic itltd/r ruljcctiiri: r;idnsc.; ict hct' iitittlti"t;!\i)1'ci:;iiis iil:s i:ncl, s',lc:s. ancl il'vicies ninin'vli ;' llirll'cilicilt.ttc :'clrtrllittll iiriiritl"s s'.uies 1'uvci'-liiuslil. insl.ca<i..ltc iilclilcls c\iie1\te luve is i's iiir aiici uliisai (i.c.. tirc ieil'hiirir siili.r-iia'riir cj'itjli'ij:lttci/,'ihc v :ii;nlililil ct' negiccl). Aiicl 1nuli1,. blclliite sitc ttt.i'iclcs tt itll.i ei-lllii'^ sirc icltvcs l,lc illiirrli t ct'tciilt'; t:"'t-''t'ittci\':l'iics-sj'lti iiliclt:c 'l siaics iix' inli irclicis t'iiir.rc. -l itclc is ltw c\il'nsi\c evicicrrc; 'riilil sit'css is ii ciilicli lilc',l' :rtili scil:i intel'liciitis. cstrccilili)'ihc i-,rlilct cillici ittlciticiilt (Sirlcr 2007). Orci'riliitri iitc iir.cilirliie. tlresc l'c:calcirers:'cpli iitill cliltilt!: iili iii.' ;lti:tl;. '::tri.lt.-;- lt.':i ll.- :;l -iiirc. i'r't;; i'"ii ''rie. e,'itlt lu.i;titive. lincl silrlcci icss n,i:i'ttriir.litci llcriblliif iil il',lt'ilctiil: r','i chilcileli. l'itcy cr.rcittcie.'or'.'rlii1. sircsi' rcrill: i lr,; ll ii:cil'lirili il\\ji'. 11i:l'Ltiti i)lli'jltl.ilig riitciiccs scilusi)'lit(i, lcsitiis iir tt lttnc, i"rlic r:rtlrct chiici iuicluctin^(srlicl c: ir1.^ l0()'/:,16). Ilt rl icvi!-w i' i:r1r issucs ibi lnc-'iitci: *'li trllilrili: ji ctli llic Str'.':':, ci1'si'.'!'ililii irl a cirill.!ctscci u'itii blclcllinc lldl')llriii,t' ciisrclcis. \cri'tttlll.t lttt(i Siiv (200:;: 392) cncili(i.. 'C'ietil'1t'" ii:is Ltrttlr i'u'tl.lct.t llle vcl'1" il-ltg clit;rict'rc.; itiliit iu'r'cis f ill'rci' t ri1' l ius riisilcss. iicil il lllclc titc;i ii,t.i critct'icircc.-i 1' eltiil abi-is. ilircl rtti:tchluctti (ii5i'liilii(.)il,il icliitrlsiiin-r. cilll l)c ic-cltltcicci ii'i,ir ihcir' \'"'1i iilitlllis." { itis ie-cllcill.tclt', ccul's ill cirisries i'r'cilliinal il'auit.ul (Schi'. 2002" 2009u. 2009b" in t-lcss). iu'tcldi:;ciirliitl'1, ci,icicncc ;l-rciir,'lircs t iulilitt^s l.ts\cirbiil:ictii :'caciil i ii\rii) iiitct'irli:;cilii site:;st'rts c() i\i, scpliniie rg')il()1tsil i)i:tr.cl'ns. iryp.'i ul,tsiti ltnci eii..scilrirlrrt. Ilc.:ltc,i36) cic:cl'rbc: ihc iititiul :iiiiic l'"miiir.il:iii'csr:aillillll: vciilitlsili )i ii:ii r;/!'(i ;:i itir-'ll :r'it'it:.,llil : ' l:lcir nc cscliaicsllc iini,:. lis iirc iirlli;rl billcis',tt lt it'l:itiic clisiies :eicl: 1. ir;t(i. iit 1i'i<;r;;,'1rr1u. l;r:lrii1,iiit'i\s t:ir. ['r ''' t.t::l::.]l arrl:,1i i.)lritc1.n" c\'cit itiricl'c\ii'jr,!c ciisil.css siqlliii lt't-:t tittr itlilll lrs t.riircl1'-tic!i1cc ircllci llvct'sitt" lttclti;lt: i)\\'ll\'... i sci'cii1'l nihci l:.cl:r:!:iir!r. i ()l' iti\ c thcr C\ir. ItO Iir'riic cullictii stlltc l iilcu'1. tirc ciiii<.i'l; sittlclctt itiiil'lii t-sitliiit' l i:'<i:caics ucli\'liilt i'iitc itriitrl'-": r'ililii ilr'trisi.rilcl.c (iil'l:t'iiel' ct tli. Iil-.. il ilriu. cvi,cs u s'"icirlcu i;rcicasc i'lirc s1,n'i'liiiic'lic i-rilt:tcit,'\ns. rc::tlling il sigltiiicait-.ly cicr'll;cil lrclit'i l'itiu (crliei;lic :lcciie itlli lc.sitic. ill.rci icsi)iiiitin. l)is1i.c:s i.; "-r.i.t:'.'sscci iit ciyitrl-. lit :ic l'c.l lll i ilg. 'i itc iitiunt':. s'rtt'c i- "ll'iiitiic t'listt,':;,s^. l' le lli lcl'i,:. is illcciii s\,lltliltilclic i.i1'p;i ai'rii-tsul lilil i:, crlricss.:c1 iir incie ll.'.cci sjcl.aiitt t;i' il-iti1 r'ciciisinli il:cir' (Citi ) iirc 'Ll'uiir^:, r-rra.ir s'rt'css ircti'ittr.rit lcsiliulcs :1'npalitciic caiccitiiilttiilc i:ctivil)' (iil',','ir ci iii

12 which the child disengages frm stimuli in the extern infants are bserved t be 'staring ff int space with and Weinberg(1997:66) nte that: when infants' attempts fail t repair the intera pstural cntrl, withdraw, and self-cmfrt. Th iund even with this shrt disruptin f the mu and break in intersubjectivity. The infant's react withdrawal f Harlw's islated mnkey r f th bserved by BwlbY and SPitz. winnictt (1958) hlds that a particular failure envirnment causes a discntinuity in the baby's ne Kestenberg (1985) refers t dead spts in the infant an peratinal definitin f dissciatin's restrictin The child's dissciatin in the midst f terrr invlv cmpliance and restricted affect. This parasympat cnservatin-withdrawal ccurs in helpless and hp in which the individual becmes inhibited and striv rder t becme 'unseen' (Schre, 1994,2003a,200 chic trauma and 'emtinal surrender', Anna Freud als referred t helplessness, defined as a state f'dis lessness' that the rganism experiences in the traum f metablic shutdwn and cardiac deceleratin is a cess that is used thrughut the lifespan. In cns stressed individual passively disengages in rder't fster survival by lhe risky psture f feigning de wunds and restitutin f depleted resurces by im 213). This parasympathetic mechanism mediates the (Baiach, pet; f dissciatin. If early trauma is catastrphe' (Bin, 1962), then dissciatin is a'deta able situatin' (Mlln, 1996), 'the escape when ther 1997),'a last resrt defensive strategy' (Dixn, 1998 The neurbilgy f dissciative hyparusal is hyperarusal. tn ihis passive state f pain-num.nig..tut piates are elevated. The drsal vagal c medulla is activated, which decreases bld pres and heart rate - despite increases in circulating a

13 3i ititiil.s\'1111)il1il'jiic i:,()tisill is ll tlli'l'ir''ri i-nt:iltr.l:r:r,ittiitcit';ilt:is iir ijlc i l:c; r-'i ii I i\\,':l silir 01 i,''i-,,'ir--r t\'',ar):l l' i \illi c\, i"cx.i!'illa ullli i{-)ilili lil'i i:'l I i',\ith0,r3lt velti:l ioilc ;s clciill;rl ::l', "iit.l ll:-r)()il11i r.ri'illlliiriilrl j' ll.-llllclcl il,ilrl.lcl.l.l ll1. iile ;-.llr.lls1'li.llllil,lutic 1.1!i.\ ()illi :\':.lc].]ll ( F.itil. ci iii.. :9!15). i '..' l:litxi,itrili:itit":l.cl5'..,rr,,':ttl: l,\l-lr-,:,:ilriic\.'r'ri-ll s\'5ici1ls. ti:ciai'l cic"ctt-ll'l:l 'liritlilillillil:11 t):"sillili: \ciliiii-\lil'iiis\':r:u;llil"iii:c:iiici:i:silillbi!r''ll:r'c-rlil''''' COittilllalti :OC:lli trticlac'ritlll: liil'.i :ic:iia il.ii e'lllll1li tl'lil'::f io'ls liii iil; ti:liif1 '.tt COillillt'.:\iCil.C riiiir lltcilli er;llc':',t)li- r11'-111;7'i1'trll: ilrl(i 1)'sllll'"i' O:: '.i:.-,,iil-, itl: :ii irl..'l"l\ tl" -lt:;'l'l': ;' '' :ii' ' ')' \': r iri\" '\: ';: "1 i^r-'titrt.l:l ill()r(), lltil';w.'\ ')! til ' 1"11' r'1'11' tltr\'il r'"':"rtl';c' ei:\':'\ ''i:"'' iltc;t.l s()ciiti sir!15\. :iuilciiliillll lilr:l:i;iiizllil()il eicliiil :cirllliilr:' ll;l<i 'llcrll:3 ir;ll:l,ictis (l)r,.l1its. 1997).,\: tll..lslti i6 iilc 1llili1ll':liiilll \'11'!11'li \'llr-:lli ci-ltltic\,i,li cit. l':tttidirl rciltlllila ciii(illlc l;ilr':'l i''r lil:ici cil!llir'llir1--il' : 'l( Cit.*rgligCllc.ti,,.,,i',l.i'.ilc:OCiili Ci,ril'tl:li'i:lill^ 1'lC tioi.tlil lillliil C()i-'i;llJ;r'COiL' i:'iit-ii.:: ic i,'\jl'a.'iiloilolllli s'illics ll:-tci llliiy l"' l:tl e:'-t"ir'l:':i::'r':'' tl1' ''Ciilre(i '"ri,:1]i:lilizlliit,'l'.'" :,ilci: i]s L'\':'clrrc 1'liii" (X)igc:' 1t)9'l: 7:)'.illili I itctc ts 1iO\\,iirti'rj,'1r1rlr1i )\'1,]-Oiliileli{j li.r1 \irti: \) It-1''l 'lul'r iit l-rl:llli'c-t:s ll.i.,ir,.iri eitrr::r.tailcrj'i ri'l1il iilc il\rtr;)ill Cll\';i()ilillJili i::lti il 'rigil i;rcl i'' cil'-!r'\' r,r.riiiizlttiitilult'l i:iili,rlliiil. *'rllc illc ;lrti'll:'1'tllpeliliii(l c():ri)rle!-'i (:"1\" tli-.l.:ltttltt,;ittllli il'i)i'l iilc Ci,:i tilli \-l1l1ii-o'il1lf il'' l:r'll ii'iiiiz'l:l icrr'" ieyci:' rli' ii.[cililii cltjlli\' (]i{ccrciitii. 2(X)3). i-1lc i1.lllr,l:l.izari i'liliili's jtl(i(icrl :\'i1'ci' lt'rn ililili-,'llli1'1i) -\\'lrllllliil':lie ll)'rl''r'il'i::' i i i<ln-cilcli.i)'-r)iii'l::r\'iili):lllrctic rri-'.'ccilt;ittit l. t'ci1ct:'rcti '-l i)i;r::;^(1997: '15)clll:lllciciiz;'ltlil 0i': lltc -ri:riti;,t lttl(i lll;litl il'liilsiii;l ll'tlil liil l.:11-ii-"(lcissiiii:"r'lt";91''i)l s1'1"iiii' r:llils iccili'ilili i't-tl::;siic s)'l-!11-'aiilciic i:cii\'ilii()il ic ill': llltlril-:;0ilcliiiv c;i- *,:ir]lir. 11n1-billzcti :ill',,: lllil.,lici;i;l1r t1cll,1l i:ss()eiill'cli'"rir1: illl: ciltll' Yi:!rill ci Il)ll\. '-.;11ii,,.';1. trr, '..1,,1 1. t)s;': 1r;'1-r;l'lit'c,:t:;;11 :ciitll' itl iljll)le -sit c-s-r: i'r1,'i5) clc;cl'lil;s'iirc sni'.cil irl'l :i\'illllili'lrliic l)i if ii:l) illirlli ilct ic lli.' I rili'()t'scd I 10'i Ji')-'1 :C)s :l' I t i ltt,q,itc,t li-oi1 llitriu-l1, lo ilrc CililliOll:Ci :'.':illoil:;") i: illc s''illlce 'rr'l evliiititli.0lt Oi'iirt- il-,tl--ncilil,: tiltng''i'i.t: ira ljili. ellt'l''<''i 'lu l.'toicicci l' r,rciliicti. Wiiir 11rc n.,r..1-,ii,rtt i'iililti ii':i',llc.srlc,ts i:l'.i-c!l:c': iall-sif ilcir\,,-) (iii1l:lci^ ilc silil..ild!1':l.i ii'

14 Slmn's (1986) classic study f attachmen a new attachment categry. Type D, an in pattern that ccurs in 80,X, f maltreated inf assciated with prenatal and/r pstnatal (Espinsa ct al ). Hesse and Main (199 tin and disrientatin is phentypically si and Slmn (1936) cnclude that Type D and that their disrganizatin and disrien alarmed by the parent. Because infants i alarmecl, these authrs assert that frighten irreslvablc bind wherein they cannt appr tin, r flee. These infants are utterly unabl t actively cpe with their frightening paren Main and Slmn detail the uniquely b Type D infants in the Strange Situatin pr brief (frequently nly s) but signif behavir. At such times, Type D infants may pattern such as 'backing' twards the paren face. Main and Slmn (1986: I l7) nte th The impressin in each case was that ap ally being inhibited and held back thr aviclant tendencies. In mst cases, ficiently'ver-rde' avidance t perm ity. Thus, cntradictry patterns were inhibited. Maltreated infants cxhibit apprehensin, c state during the Strange Situatin. Main a the child's entrance int a dissciated state: One infant hunched her upper bd mther's call, then brke int extrava excited fbrward mvemcnt. Her bray distress-face withut a new intake frward. Then suddenly she became sil

15 ngtli)' lrncnt blrrin n anci citi,-'tl cntecl rnrl is ic LlSe tntt',t- NIuin faltcc lnt i..: u'hcn in iur rtlenatc 11)' h-lcl 1ii1'cc1 nizcri avil lcj t ttitiu- )n ()l' sui'- xinrtiaii1' l'ts t' cribc I ircr' lh au ancl Lche ci 'fhcsc bclurvlis alc lli l'cstrictccl i thc iliilnt's iirtct'ac'rins n'l ltiiicr'. Irrcic;ci. tirc intcn:,i',1' i tirc lleb1''s ci1'slcltiiilicci afl'cclir c.t licu hci3hicncci u'hcir thc illl:r1 is.irsccl i tirc uciciccl :,ti,:-.s iiliiiii.itilitil-i)jisit. Ai l: stirilrg"'r':,';l'.r'.rirc... tu' inilirls nrveci li., ltv Lrili ll-rihet'ilncl s'r.r'ani:cr-1 iircc lirc iiali: uirillct"lcitncci iil'chcati.l iire ri'lli 1b;' scvcl'ui sccncls. ii.iiirg blicir in allirli'.lli icnr". I hc:c in crltibit 'bchavil'ai stiiillg" thai is. 'cl:rzcri' ir..iravi;' ur.ii-l crcllcsst-ti bchuviral ntanil-cstutins t'ciissciililu. Onc iiriitnt 'irccllrrtt iiti' lt ltr crccssit,cly s'.i11. stuling ini :;ac"' a\ iirugir ciirirlcicll iii i-eir:ltc scil-. cnviliuncnt. ilnti paicni". Anillci' situ'eci 'a ciltz,--ii 1l:cilll ltrlitca... ucclllltinlc b1'll siiliill: i'lril 'b<lf nvt'ncnt^ iii.ici s,l'tctit',tcs u ini: 1'linbs u'iricli i'racl becir in rntin". Yci unihcr''icii lacc-citt'lt 1'li iu ir clclrrcsscci il():tillc 1-rlil itr srir::r'.rti'r^ stiliinri lill bciy lttvci Gr-rcrtcircl'uncl I--cl'nlinian (200i)licr an ullilt-l ciisirc,ss sc:l1e tltitl tls thc siistainecl x,itircl'ar-,'iii that is u:sciatecl with ciisr!ri:nizecl attitcll 'l'iris u'itircilarval statc is crirr.essccl ir llz:en" ubseut iitcirii c:'irr'.':sirt In'icianc.' l'c1'c- cutaci. iininbiiiil,. abscrrcc i'r'caiiziitit-r. iiltsct l'clutirrli i ctiicr',.. lind tirc implcssiu iirai thc chiicl is itlt1'nci lcacit. Dissciatin in iiriirnts hus uls becr.r stuciieci u'ith ihc Stiii-l:acc lticc ait c\ltcf ilncitlul palucligur i-1r'iiumatic ncgiecl. Iir tiris 1-rt'ccciiit'c. liic is crir:;ccl 1 a scvcrc rclitiillitl sii'c:;st': ihc tlihcr n'iaitttliil.t: c]'c c ri'iih ihc initini^'irr.ri,ihe silclclcllf inhibits ull vcalizli'ritt auci susitct cmiinaliy cxltlcssivc f acial cxprc:siirs ai.t<l iresturcs. tr'iris sevcic iniri l nrtr'ei'itiil crnmi.u.ricatin anci iulcl'uctivc afteci icgirluiitr tl'i!tgt ir.iiiiui incr'..asc 1- inlcluctir'e bchll'il lir.rci ultrsll ilr ihc ilfuitt.,,\cc t-il'iticl; (200,i). tire iiilirni's cntuslr.i iiurl iiitriiilncss rtl lltc bic cnuectic'xi is accrtrilrnicri b1'tirc itica tllat'ihis is iiilca'.cling^. i'iiis li iir'ien-silicuiiir is ullin'urteiy 1'lli','cc1 bi' bdii;, c11lii'l-.c. iss i- ir cniil. r.,'i'rirci-iau,ai. rriizc livl'rsil" sac! iircial elprcssil. linti :;t11'-.ccti'. bchlivir'. Furthclilrc^ tiris bcirai'il is uccmi.xrniccl by a 'clisslpiltin i'thc llt siaic 1'cusciusr.rcss^ aiicl u cilrinisirnrclit L scil'-rlranizing altiliiic lcllcct 'clisrqunizaiirr f iiranl' 1- ihe lrvct' 1n'cl ns;'cirbiigical sricir as nciiiblic s),stcrrs'. l{cciiil that ciissciutin. li ii5'ltl.t.tctablic irirs irccr.r ciciinccl in thc Amcr'icun Psychilltlic As;ciiitin^s.1)ragri,st Stt lislitttl,l'luirtrul as 'ii ciist'udtiir. irt tiic tisitall,r' irttcgl'atctl lirncti cctr.rscit-rsncss' anci ricscl'iireri as "il iritcctivc aciii.'itiin i-aiieicel sta cirscitisncss in icactin t vcl'rvirclr"iriuri 1'rs1'clligiclii initil.)iil" ([- sicir" i99(r). llnicil (200.i) sugllcsts tha'l influrts tvlt nll'c.l iris'r ciir"nic bi,--alis i' enlicctins!-xiribit ur-i 'crtt'ctircly i-iliiirigtcltl sla clltilal apuiliy. I.trc ecluutcs this siute li'rth Spitz's cllcci)l l'lisltit anci I{r.nanilii.r ctlirliaus ri'li liiii t srtxi arrrl clcvcitl. Stich iniituls r-ri1 il aclpi a ct'rr.nrrtuiricutin stylc i'"stay rnvit1,. cln'i cnncct". l-hi: clstaltcc is u vcly r'aiiv-ir.riiriil'rg" yct alrcacil,chi'iiic. nrthigical clis:ttc

16 in a hunting psture; expsure f canine tth a grwls directed at infant'. Thus, during the tra with an aggressive expressin n the mther's fa sive face and the assciated alteratins in the in ibly imprinted int limbic circuits. Main and Slmn (1986) dcument that Typ a secnd kind f disturbing maternal behavi fear terrr. This ccurs when the mther wit thugh the infant were frightening. Indeed, studi Type D infants exhibits dissciated, trancelike, a research underscres a link between frightening atin, and disrganized inlant attachment (Schu wrk, Hesse and Main (2006: 320) bserve tha dissciative state, a fear alarm state is triggered i entrance int the dissciative state is expresse pletely "freezes" with eyes unmving, half-lidded parent addresses infant in an "altered" tne wit devicing'. In describing the mther as she sub nte (321): Here the parent appears t have becme c r even [un]aware f, the external surrund verbal behavir f their infant... we remained seated in an immbilized and unc hand in the air, blankly staring int space f In an early histry f traumatic attachment the t frequently expsed t a massively misattun triggers and des nt repair lng-lasting intens grwth-inhibiting envirnment f relatinal traum lnged levels f negative affect assciated with hyperarusal and hyparusal. And s fr self-pr restricts its vert expressins f an attachment The child thus significantly reduces the ut emtin-prcessing, limbic-autnmic attachm stressed, defensive functins are rapidly initiated

17 Ncurbilgy i attachm ncc 01' lil ancl rthcr. ld. but tgglcr- Ltcning l fburs 3: dccp 'seniccl 0untcr in 1' irnt us ivcl l Iun'cnt lggrcs" indci- Lis:,circccnt rtgrs i.t givcr's I COll-lcrncnt: rg anci c. thcy ivc t. ai anci r lr4r ith hcr ldlel is :r'ri4r :s. 'I'hc rcl prrlcs 1' :r'eici1, latin. Lalizccl nc is : brain irtn inlcractivc i'eglrlatly rrcics int lng-clciut'ittg. iess cnpicr altt latt'l,r'ncles. l'ircsc pattet'ns arc plimitivc stratcgiics fbi st"il'vivai thiit t nlinc lbr lngi iutcrvals ltimc. pclids in rvhicli thc det'clpirtg brairl hyprnctablic statc. detrimcntal t tlic suirstat.rtiiil aii-ittttts f rcquirccl lbl clitical pclicl bisytttirctic l)rccss!-s. I)uring thcse cltisdc-s. tltc inlant is uratcliiug tlie rltf ilimic structit ihc mlhcr's dyslcgulatcd statcs. ancl tltis s1'ncht'nizaiin is rcllistil tiic fir:ing pattcrl-rs 1' tire stless-sci.rsiiivr: cltical aitd liirrbic icltitrs intrlt^s blair.r. csltecialll' rn thc nght bi'ain ivhiclt is in rt critical itcli grivth. lntants dcsigttatcci iis '\'cf)' fearl'u1' ai scvcll mulils shrv IRPs vcr thc right hcmisitirelc u'hcn vi.,'ir.tg i'carllri fitcial critics (Dc IIaan ct a ). An EIrG stucly t'iivc-mntli-c'rld inlirnts b iircrcascd tlicta activity vcl thc light pstcrir tcurpral alell rvliiic tlt lking at a biank t'acc (Bazhcnva ct ai ). It is uu'cstablish.-ci that nraternal carc infltienccs bth thc inf lrnt^s t' ity (Mcnald ct al ) ancl the ililant's dcl-cnsivc respnscs t tlrrcat ( ct a ).'i'hcsc ci)'arlic prccsscs'scrvc a:' tlic basis fr tirc transtniss inclividual clillcrcnccs in strcss rcspuscs li'lir mthcr t lfslli'irtg' (W ct ai.^ 2004: ii47). Ilccausc mally mthcls suflcr liur Lurrcslr,scl tt'ar.rma chatic anci dysrcgulatccl altcratins l stiltc bccllrc impriniccl ir cicvelping braitt ancl scl1'-systetl 1-thc child. I-ltis iutetsubicctivc p plthgcnetic r.ncclianism thns rlccliates thc psychbiigical intcrg tinal it'ansrrissin l bth lclatinal trailtnir ancl thc clisscialivc d asainst verrvhclrning and ciysrcgtriatitlg all-cctivc statcs. In accrc this ndcl. rcsciirch nu' inclicatcs i.hat scvct'c cat'1y tnatcltial clyslt is assciatccl ivith high tlissciatiu iti psyciriatric paticuts (Dra I-a1gcl1nc )" anci that ph;'sical abusc alcl paicirtltl ci1'slituct tire part cli' thc rltircr nt thc llither is assciiited rviili strta dissciativc syurl-rttls (Re1li ct ai." 2002). Irrm a cievclpmcntal psychlgy vicivpint. tilc prlbund llegitti\ chlgical cti:ct f rclatinal tlatttna (carly abusc atlci neglcct) is tirc irtin f' a disrgauizt:ci disliciltcil attachr,icnt that cudttres v latcr stagrcs l chilclhcl. aciicsc,-'ucc atcl adultltd. ancl acts as fi:ctr ir latcr psychiatric disrdcr:s (Schrc.200i a). F cleyelpmcr.rtal ncurscicnce pcrspcclivc. tire imr.nccliatc delriurciltai itn ir thc altcleci n-rctablic prccsscs tirat nlly sustain critical pclid l thc clcvclping right blain. anci tirc lusting irnpailrlcnt is an immatr.t lunctinally lirnitecl right-brain capacii)' t rcgriiatc latcr iil-'^ strcsstl gcncratc intensc all'cct siates. Rclatinal trautnrtlic L'\p!-l'icnces at'c st imagistic prccclr,rral lncmry f ihe visuspatiai rigirt hcmisphcrc (S ct a ). the lcr-rs f'irnplicit (Ilu.gciairl. 1995) and ar-rtbigla (Marlirvitsch ct al ) ircmry. 'l'ltcsc psychlgical and bilgic spcctiv!-s cu!cigc n a basic dcvclgdmcntal u'irlciplc f'rcgulatin th that carly trautnatic sunclcrinli f attachu-rcnt trtrcls is critical t tlic-

18 Neurpsychanalytic authrs nw cnte dminant experiences f separatin. dist g drvn a bad pathgenic develpment psychlgical pathway but a bad neurl Current wrkers in the field f develpm the verwhelming strcss f maltreatmen adverse influences n nt just behavir, bu et a ), espccially the right brain w negative affects (Davidsn et al., 1990 erntin-related prcesses' (Sullivan & Du tial survival lunctins f this lateralized s The right hemisphere perates a distr ing t dangcr and ther urgent pr envirnmental challenge. stress and respnses such as avidance and esc brain's 'red phne,' crnpclling the withut delay. In states f pathlgical dissciatin the r The right brain is fundamentally invlved ism fr cping with emtinal stress. inc f dissciatin. Thcsc adaptive right brain f early relatinal trauma. A large b and neurlgical studies supprts the lin pathlgical dissciatin (e.g.. Dikel et a Merckelbach & Muris.2001; Macfie et al. Recent neurbilgical data can als psychpathgcnctic mechanism by wh impacts right brain develpment. Adam experimental data that 'implicate neurpl circuitry in mediating lng-lasting change but severe stress'. Accrding t Gadea negative affective experiences activate th experience 'might interfere with right he damage if sme critical pint is reac

19 Ncurbilcgy f attachment irh r'ili,ilcl 9). rat ith ili s it ir nci ir'c lhr cfs luci. IO- 0t- rclscs,111- :, 'lcs.,! Lncl 04: iirc 'cl)' 11 bic 'icf' 'ate nsc rual r llt hyclalr-rsal-inciuccci allptiic ccli clcatii ir-r thc li1'pct'titciabiic i'igirt blai 'firu-.^ via u switcir in.i li irypari-l-qai. a h1'ptnciabiic stilic alirvs tbr c slilvival at titnes f intensc crcittric sti'cs:j (Sclil'c. 200 l.2002). I{ccali tliat light cilical arcas anri thcil ct.incctit.ts rvi'iir light sribcrtic iitlrictrlrcs arc itr ir, clitical pclici i'girvtir cluritrs cartrf i'ir-ular.r clcl'clpmctr 'i'irc ir-nssivc ltsycirbiigicirl sii'css as-sciatctl n'itli attaclmcrlt trlilli ir.ppails thc cicvciltrncnt f'this systcnr. iinci scis thc stagt ibl thc clttirltctcr iglticai usc 1' r'ighi-blain itatirlgicnl ciissciaiin u'hctl encrtt.ticrirlg lat sl1'cssi's. C'nvcrg:ing 'iclcncc iiiciiclllc: ihat elir'ly abtise ncgatir'cif illlpitc liilbic systcm rnrt'irrratir.r. plilucingi cncluliug ncut'bitll-sical alt.-r'tti. ihlt gi.rcicrlic ail'cctir'c instability. incliicicnt stt'css tlcraucc. llll'm implili.ircr.rt. ulcl clissciativc ciistuibances. Itt titis tnlttrttet'. tt'alttlaiic stt't-ss cirilclircl icacls t sc11',r.nclulatin f paurlui ali'cct by ciii'cctirlg llttcrlti lil'a1' 11't.n intcrtrai r-intintll staics (Llttlc ct al.. 199'/). Iirc righi bra ciminant ibr attcr-rtilt (l{a2.2004) and ilaiti 1-rt'ccssin-u (Synincls ct a 2006) thlis gencl'atcs riisscititin. u clciinsc b1'u,hich ilttensc ncgativc all-c assciiitccl r','ith cn.rtinal pliin a c blcliecl il'i.t-i etlit:e iusllcss. Cl.rgt'itcui u'itli this cicr,clpl"r.rcirtai ucici. Spitzcr ci lii. rci.rt't a iral cilinial i.nagnclic stimltiirtirl stucil' 1'uclulis anci 'lti cc'rttcl,-tclt-, ciiss,rc:irrli pl'rxtc incliviciltals" li trarilna that is pei'ccivcd lttlci pt-c.rc.-sseci b1' the lig cltisphclc q,iil lcacl t a 'clisintrtin in tltc '.rstritlh' iiiil-grated lttnctins c!t\eiy:ltc::'(lot)i: i6s; Irr itrnctir;rrl nlitr-illjtie les()ilirllcr irrrltgi rcsculch" Lalius ct a1. (2005) shrv lrlcdminiintiy rigirt hcrlisplicl'ie ac vaiiu in ps1'chiatric paticnis tvhiic thcl' alc ciissciittin-u^ aitcl cnch.rdc ih clissciar,ii.r. rrlt cscapc ll'm thc "'elr',,hcitniug clur.iiis a-.sciatcci li'ith iraul1a1ic ilellr)/. catt bc itrtcrpictccl as rcprciclltiilg a nllycrbal lcspr. t thc tlar,rmlilic t"itcutt'1'. Ill tire ciinicrl litclaiut'c. Ih'nbcrg (2006) lin rigirt-biain iialtuta t lttitttnric hypct'arusai^ 'a chatic ancl tclril,vi lldiltg f'aliect tltzil- caii iittcaterl t vcru'liciln sanity ailcl impct'il psych lgicul sr,rrvit'ai'. Dissciutiir is tirct-i altiiliiticalll'aitcl inmcciiat tliggclccl us thc lirnciai"ncltal clclcnsc -i iirc itt ns:r1 d1'sl'cgulaiicltl vcru'hcintiug: a l'icct ivc statcs. IJiit icscuiclie rs anci cliniciiins arc n\\' r'xplring tl-rc cviutit-l f a cl pn-rcntaliy iltpai-,'ccl rcg'.rlzrtr'1's1'stcn't llitcl prvidc';r'iclctlce thiit plcli'n crtical anci iin-rbic ar"cas 1'tirc ligirt ircrnisphclc at'c ccntiitllf inviveci itt cicljcits ii"r lirincl and bdl'assciiiicci u'ith a patirlgical cii:sciativc rcspn (Scir1u..2002^ 2009a.2-009b. in 1-ricss).'I'iris ltcmislthct'c. urtc than thc icli clcnsciy lcciplccally inici'cnnccteti rvi'iir L'intilr-prcessing lirnbic l.csi as rvcii us rvirh subcltical arcas lhat l'cncraic btit tlic at'rtsai atlcl au nmic bclily-basccl aspccts l cn'rtins. I{ccall. SNS aclivit)' is illanifts tigfit cngilgcll.rcr.rt rvith thc crtelnai cil'iiument ar"rc1 a high l*,cl l cilc rubiiizaiiu^ ri'hilc thc itallisyrnpu'.hctic cnlllltcitt c1t'ivcs cliscngallcnr fl'in thc extclrrai envirnu.ict'rt ancl utilizcs!u' lcvcls f iiitct'uai cllcl' -i'ilc:;c ANS cmpnetis ut'c r.rncr-rirlcci iirl ing pctitis i'time iu stlcss

20 1994 cmpnents f t'nti'ili 'i"-'"t-tstrire' peratins f defensive dissciative prcesses traumatic expe'encc ;;;i;lrn^ttt in the hc nding images in tht'tinj nj tn"'"uy un un tbliterated,. Nijenhui"s?ffi.; ;r;;,,,r.ru, 'sm utcme f early r" i'uu-atizatin t*p^'*j sensrimt,.^p"ri.l..;, ;ii;;;, ana'frrr,"ti representatit. Di";;;;;i"^ttt-;;dta nii"ij rrm the.nulrn*tn'l;;;;i'"-r; 11 '3ii - their sense t ra.nt,tyi,iit.n'"i ur, r999t- This right.cli'r".;i;;ii hemispt,eric t."intr.y describe 'a disscratrnlt'*ttn rhe emtinal hvsilgicat,"u"ti#^tl'itui-"u.n,, with the inil, tigit hemisphere lunctin" In a numbe, "f *;;k;^i-r1uu. r.r. inter -U" implicit selt, equated *lti'' pttt'a's system (Schre, 1gg4,200.3;,ZOll Thg.lSwer tuu* (the deep.tn"n'"tj"i""tuin all the majr m attachment, r.ur,,.i*iiiy, uggr.rrr',,.etc.) a nmic expressins "r;^"""rr"r intensities ther hand. high";';;i;irr.,*r-ri-uic le senerate a cnscius emtinal state tlrat t^ ihesemtivatinalsystems.inanpttmalai lateralized niera'ct'ical prefrntal system' the tial adaptive nlrti"uillriji,rn.tin - trr. t.iut bdily based states;;;;""" t changes in are nncnsciusly upp'it"a t be.p.ersnall In cntrast, '"rutillt'uiiiuuma elicits mre cgnitin and a. Oil"'g""i"tin.f vert b the early 'run"uiij'i ilignt brain-surv beneath levels f t"""i*t uiu"n""' raih in a maladaptive highly defensive 'igla' tftt t even t* t.u"tr'i intersubjectiu.,ir.t vagal parasvmpatieiic ;;;;;;;;;!1.1"" disengagement' This fragite ""tn'"i"'!.tv stress-induced #;i;?f metablic :;i6

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