Neuropsychoanalytic Findings in a Patient with Bilateral Lesions of the Amygdala

Wiest, Gerald; Brainin, Elisabeth

doi:10.1080/15294145.2010.10773646

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…with bilateral amygdala calcifications due to Urbach-Wiethe syndrome was described (Wiest & Brainin, 2010). This patient had sought treatment due to new onset panic attacks and depressive symptoms.…”

Section: Neurobiology Of Attachment 551mentioning

confidence: 99%

The Neurobiology of Attachment: From Infancy to Clinical Outcomes

Chambers

2017

Psychodynamic Psychiatry

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Attachment theory was developed by John Bowlby in the 1950s. He defined attachment as a specific neurobiological system that resulted in the infant connecting to the primary caretaker in such a way to create an inner working model of relationships that continues throughout life and affects the future mental health and physical health of the infant. Given the significance of this inner working model, there has been a tremendous amount of research done in animals as well as humans to better understand the neurobiology. In this article the neurobiology of early development will be outlined with respect to the formation of attachment. This article will review what we have begun to understand as the neurobiology of attachment and will describe how the relationship with the primary caretaker affects the infant in a way leading to neurobiological changes that later in life affect emotional responses, reward, and perception difficulties that we recognize as psychiatric illness and medical morbidity.Keywords: attachment theory, neurodevelopment, oxytocin, hypothalamic-pituitary-adrenal axis ATTACHMENT THEORY: A BRIEF HISTORYThe parent-infant bond has arguably been the most important process for human survival. While the importance of the mother-infant attachment has been understood for centuries, it was not studied until John Bowlby developed attachment theory in the 1950s. In order to put attachment theory in proper context, one must begin with a reminder of Sigmund Freud's drive theory. According to drive theory, we attached to our mothers because they fed us and gratified our oral yearn- NEUROBIOLOGY OF ATTACHMENT 543ings (Freud, 1923). In other words, our attachments were derived from our libidinal drives and did not exist independently. Drive theory was largely a one-person psychology focusing on the drives and conflicts of the individual; our mother was simply an instigator who either gratified or displeased our internal drives and wishes.Melanie Klein led us to a two-person psychology where the other person was more than an instigator of drives and wishes. The mother, in particular, shaped the psychology of the infant through representations of the good and the bad breast, the merger of the two, and the hope for reparation that allows us to stay attached to our mothers. Klein introduced the idea that we need to feel hope for reparation to stay connected to our loved ones in spite of our own aggressive drives (Kristeva, 2001). For the first time, the object had relevance in our psychology, though Klein believed that the emotional problems of children still came largely from the fantasies generated by internal conflict related to the object.John Bowlby was a supervisee of Melanie Klein and was influenced by her, however he argued that children's emotional problems do not stem from their own internal conflicts based on a fantasy of the caretaker, but rather their emotional problems stem from actual experiences with their caretakers (Bretherton, 1992). Furthermore, Bowlby suggested that the need for social b...

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Section: Neurobiology Of Attachment 551mentioning

confidence: 99%

The Neurobiology of Attachment: From Infancy to Clinical Outcomes

Chambers

2017

Psychodynamic Psychiatry

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“…These studies, however, did not explicitly localize lesions to specific neural structures such as the amygdala. More recent publications presented patients with Urbach-Wiethe disease who had bilateral medial temporal lobe lesions associated with decreased dream recall (Wiest and Brainin, 2014).…”

Section: Commentmentioning

confidence: 99%

Acute Effects and the Dreamy State Evoked by Deep Brain Electrical Stimulation of the Amygdala: Associations of the Amygdala in Human Dreaming, Consciousness, Emotions, and Creativity

Lai

Langevin

Koek

et al. 2020

Front. Hum. Neurosci.

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Acute DBS of Amygdala negative responses and 2-4 V stimulation showed inversely coupled positive and negative responses of the amygdala in either hemisphere which may imply hemispheric dominance of emotional valences without relation to handedness. Due to the unique and complex responses dependent on location and strength of stimulation, we advise that all patients receiving DBS of the amygdala undergo acute stimulation mapping in a monitored setting before selecting therapeutic parameters for chronic stimulation.

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