Full Text

This article discusses how recent studies of the right brain, which is dominant for the implicit, nonverbal, intuitive, holistic processing of emotional information and social interactions, can elucidate the neurobiological mechanisms that underlie the relational foundations of psychotherapy. Utilizing the interpersonal neurobiological perspective of regulation theory, I describe the fundamental role of the early developing right brain in relational processes, throughout the life span. I present interdisciplinary evidence documenting right brain functions in early attachment processes, in emotional communications within the therapeutic alliance, in mutual therapeutic enactments, and in therapeutic change processes. This work highlights the fact that the current emphasis on relational processes is shared by, cross-fertilizing, and indeed transforming both psychology and neuroscience, with important consequences for clinical psychological models of psychotherapeutic change.

In 2009, the American Psychological Association invited me to offer a plenary address, “The Paradigm Shift: The Right Brain and the Relational Unconscious.” In fact, that was one of the first times an APA plenary address was given by a member in independent practice, and by a clinician who was also psychoanalytically informed. Citing 15 years of my interdisciplinary research, I argued that a paradigm shift was occurring not only within psychology but also across disciplines, and that psychology now needed to enter into a more intense dialogue with its neighboring biological and medical sciences. I emphasized the relevance of developmental and affective neuroscience (more so than cognitive neuroscience) for clinical and abnormal psychology. And so I reported that both clinicians and researchers were now shifting focus from left brain explicit conscious cognition to right brain implicit unconscious emotional and relational functions (Schore, 2009). Only a few years before, the APA explicitly articulated its new found emphasis on the relational foundations of psychotherapy. In 2006, APA Presidential Task Force on Evidence-Based Practice boldly stated—

Central to clinical expertise is interpersonal skill, which is manifested in forming a therapeutic relationship, encoding and decoding verbal and nonverbal responses, creating realistic but positive expectations, and responding empathically to the patient’s explicit and implicit...