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Today what I want to do is I want to kind of briefly talk about modern attachment theory and the enduring impact of early right brain development on affect regulation. So as Mary said, my work essentially for the last two decades now, over four books, including a recent one, which I'll talk about soon, has been on this regulation theory which is an interpersonal neurobiological model of attachment. And again, What I'm interested in as the clinician scientist, not a scientist clinician, but a clinician scientist, who for decades has also worked as a psychotherapist, is the development, the psychopathogenesis and the psychotherapeutic treatment of the right brain implicit self. So, in 2008 Judy and I wrote an article on Modern Attachment Theory, the Central Role of Affect Regulation and Development and Treatment. And, following the work of John Bowlby, who I've been tremendously influenced, we said the following: We suggest that in line with Bowlby's fundamental goal of the integration of the psychological and biological models of human development - and that's where I have been, literally at the interface of attempting to bring the psychological with the biological. The current clinical and experimental focus on how these emotional bodily-based processes are non consciously interactively regulated or communicated between human beings and regulated has shifted attachment theory to a regulation theory. In 2009, here in Toronto at a the National Conference of The American Psychological Association, I was Invited to present a plenary address and in that address I talked about what I see as the paradigm shift that is now occurring actually in all fields of science and clinical fields, but also in models of attachment. And essentially, what I'm arguing for is that I now see are three converging themes. First of all, in psychology and in neuroscience, shifting more and more from cognition to emotion. Actually, in 1994, the subtitle of my book was the Neurobiology of Emotional Development, and up until that point in time there really had not been written a book on emotional development. In 2007 in the journal Motivation and Emotion, it's a technical journal in the field, the editor (xxx) says, after three decades of the dominance of cognitive approaches, motivational and emotional processes have roared back into the limelight. And so I'm suggesting that attachment theory is shifting from the late 60s and the early 70s from a behavioral theory into the 80s and partly into the 90s as a cognitive theory and now into an emotional theory of early social development. The focus now is not so much on the development of more complex cognitions, but on the communication of emotions in the first year of life and on the regulation of the child's ability ultimately to be able to regulate these emotional states. And that as I see it, the key aspect of the first year of life is the maturation of these affects. And again, affects communicated in a relational context. And more and more we're seeing in the clinical fields and in the scientific fields this focus on relationships. This is also now impacting models of infancy, and again what we're suggesting is that these, now seeing attachment as the origins of emotional well-being. And as you're well aware, emotional well-being really is turning out to be a key, not only in childhood but in adulthood - and this from psychology to psychiatry. The second theme of the paradigm shift revolves around a construct that is used in literally every area of science: the concept of self-regulation. And the emphasis therefore has shifted from not just emotion but to the regulation of emotion. And so my colleagues Peter Fonagy - in one sense we can consider the whole of child development to be the enhancement of self-regulation. And that ultimately at the outcome of infancy and childhood is the ability here to regulate these affective states. Self-regulation is also tied to stress regulation as well as emotion regulation especially stressful emotional affects. And also the disregulation of affect now, especially in the critical period of infancy - a critical period as I'll say/show of right brain development - is at the core of psychopathogenesis. And later I'll speak about this, but just about every psychiatric disorder shows problems in emotional disregulation and the neuroscience is now showing right brain deficits that are set up early. The third theme of the paradigm shift arises from the tremendous surge of neurobiological data during and after the decade of the brain. Actually the decade of the brain was about the mid 90s to about 2004/5. Developmental neuroscience especially, I would suggest, developmental affective neuroscience and developmental social neuroscience, are now actively exploring the brain growth spurt. And I'll show this - the period in which the brain grows, the human brain grows - more than doubles in size from the last trimester in pregnancy through the 2nd year of life. And the studies are looking more intensely neuroscience at this period of time and also on the development of right brain functions in this critical period. And I'll give you some examples of this developmental research. And so, in 1994 in my first book, I suggested that the evolutionary mechanism of attachment and it is now known that attachment again is more than humans, we're now thinking it's actually more than mammalians but it actually, may be with all vertebrates, this evolutionary mechanism of attachment is occurring in this period of massively accelerated brain development. Attachment expressed in relational right brain to right brain communications between the mother and the infant These emotional communications, I'm suggesting, actually shape the capacity for self-regulation. Studies are now therefore shifting from later forming verbal cognitive functions of the left brain in the 2nd and 3rd year, to these early developing emotional social brain in the first year. And here you see on the charts Actually the top is white matter, the bottom is gray matter but look, here Between 0 and 24 months you see this tremendous acceleration of the brain occurring at that period of time and then it kind of levels off. So the focus is on this early period when the brain is doubling in size. Due to this massively-accelerated development of the early brain, infants and toddlers, I would suggest, as opposed to all later stages of life, have unique, essential, emotional mental health needs. And actually next month in Chicago I'm about to deliver this information to a thousand lawyers as the legal profession has also become very interested in the matter of early development and and in infants. Last year, in the Journal of Child Psychology and Psychiatry Leckman and March, in an editorial described quote, "The phenomenal progress of the past three decades in the developmental neurosciences." They say, "Over the past decade it has become abundantly clear that the in utero and immediate postnatal environments and the dyadic relations between the child and caregivers within the first years of life can have direct and enduring effects on the child's brain development and behavior." Actually, this was a an aggregate of about 15 articles in the journal on this particular theme. And these authors go on to say, "And indeed the enduring impact of early maternal care and the role of epigenetic modifications of the genome during critical periods and early brain development in health and disease is likely to be one of the most important discoveries in all of science that have major implications in our field." And again, this is the Journal of Child Psychology and Psychiatry. This brain development, we now know, was more than just genetically encoded. It needs epigenetic social experiences provided in the mother-infant attachment bond to move to further complexity. So now we're talking about gene environment Interactions, we're talking about models in which mother nature is integrating with mother nurture and that severe problem between psychology and biology is being overcome by these bio-cycle social models. Champaign...Actually...Michael Meaney's colleague "What's exciting to me is that the social world which can be perceived as being this ethereal thing that may not have a biological basis, can affect these mechanisms - the social world." So in my most recent book, "The Science of the Art of Psychotherapy", I'm continuing to offer interdisciplinary research on how the mother-infant attachment relationship facilitates or inhibits for better or for worse the experience-dependent maturation. Notice the maturation of the brain needs experiences, it needs social experiences. And the maturation of affect regulation circuits of this emotional right brain. Regulation theory, interpersonal neurobiology, and modern attachment theory offers pragmatic implications in this book, and there are chapters in this book that I've written as Mary said in different fields Not only in psychotherapy but in developmental psychology and child psychiatry, pediatrics, clinical social work, psychoanalysis, infant mental health, behavioral biology, and indeed family law, we're talking about the larger cultural implications of these, which actually the Roots of Empathy is also directly impacting. So in the following I want to give a brief overview of this work, Including, I want to also really emphasize some thoughts about empathy and what we now know about the importance of empathy which is a function of the right brain. So here, this was the first book and I've suggested there is now agreement that the essential task of the first year of human life is the co-creation of a secure attachment bond of emotional communication between the infant and his or her primary caregiver. The baby communicates its burgeoning, positive emotional states: joy and excitement, and negative emotional states: fear, anger, depression etc., to the caregiver so that she can then receive these communications and then regulate them. And as I'll show, there's more interest these days on the positive emotions, Not just the mother down-regulating negative emotions but the importance of the positive emotions of joy, interest, and excitement. The attachment relationship shapes the ability of the baby ultimately to communicate, not with just the mother, but ultimately with human beings. And again, I'm going to suggest that's through the shaping of the right brain. In 1969 in John Bowlby's first book "Attachment", and Bowlby was attempting to integrate at the time developmental psychology and psychoanalysis and behavioral biology, and he said in his first statement of his theory, that the mother-infant attachment communications are accompanied by the strongest of feelings and emotions. That, essentially, the attachment bond is an emotional bond. And they occur within a context, he said, very specifically: facial expression, posture, tone of voice, physiological changes, tempo of movement, and incipient action. Following Bowlby in 1994, I suggested that in episodes of visual facial, tactile gestural, and auditory-prosodic (prosody is the emotional tone of the voice) the sensitive primary caregiver is receptive to the infant's bodily-based attachment communications. These communications are not occurring through language mechanisms Broca's areas, Wernicke's areas are not really maturing optimally until the second year of life, but through the first year of life, they are occurring through these nonverbal emotional communications. So here we see through the eyes as they are reading each other's facial expressions, through the baby's voice the tone of the voice which is being read by the mother, mother-ese, and also the tactile gestural through the communications of their bodies. Now in order to process these relational communications, this is the first relationship the primary relationship in which the baby is learning how to interact with another human being. The infant seeks proximity to the mother who must be subjectively perceived by the infant as predictable, as consistent, and especially as emotionally available, more than just cognitive but emotionally available. Secure primary attachment figure as I said not only down-regulates negative states but up-regulates positive emotion in play states. And this has been also a shift because, we used to think, Bowlby originally thought that the reason for the attachment was that the mother was down-regulating fear states for the baby, as the baby came back to the secure base. But as I say again we now know that these play states, that these positive states which really involve the dopaminergic reward system are critical to brain development also. So, we're looking for a mother who not only can soothe and calm the baby but can up-regulate the baby in these play states. Again we're talking therefore about different emotions and we're talking about, on the one hand, joy, interest, excitement, As well as the negative emotions. And just for the record, the idea that all positive emotions are good and all negative emotions are bad Is a fallacy. Essentially, the ability to experience fear, the ability to experience loss, this is critical at certain points in life to be able to also tolerate actually the negative emotions of guilt and shame are part of all moral systems. So again here, the baby is learning now how to be able to communicate; to Internally understand and to have these emotions across the realm. The baby thus becomes securely attached to the psycho-biologically attuned, because the baby is reading the internal states of the mother. The baby is, the mother is reading, again, the internal states of the empathic caregiver, and the truth of it is that the term empathic caregiver is legitimately used in attachment theory to designate the mother's capacity to be able to resonate with these different kind of states, and this caregiver therefore minimizes negative affect and maximizes positive affect. It's the emotional availability of the caregiver in infancy which seems to be the most central growth-promoting feature of the early rearing experience. And the development over the first year therefore is what's called an expansion of the affect array; that the child now has increased tolerance for both positive and negative affects. The researcher Joe Ledoux, coming out of neuroscience, who has studied fear states, "The broader the range of emotions that a child experiences, the broader will be the emotional range of the self that develops." This also allows the child then to have empathy for others who are also in similar states. The child to have empathy not only for a child who is also in an excited state, but also empathy for a child who's experienced a depressive loss. So these attachment communications I'm suggesting for now two decades, are occurring between the infant's right brain and the mother's right brain. On the matter of the infant here you see the right hemisphere can be considered dominant in infancy for the type of visual facial and acoustic prosodic communications which is relevant for the pre-linguistic child. On the part of the adult, the primary caregiver, we now know that the neural substrates of the perception of: voices, faces, gestures, smells, pheromones, as evidenced by modern neuroimaging techniques are characterized by a general right hemispheric functional asymmetry right brain to right brain. More specifically, when it comes to visual facial - reading each other's faces - in 2007, in Germany, Grossman studying four-month-old infants presented with images of a female face gazing directly ahead show enhanced gamma electrical activity, over the right prefrontal areas Another study by, in Japan a near-infrared spectroscopy research reveals five-month-old infants right hemisphere response to images of adult female faces. And earlier Tzourio-Mazoyer had shown in a PET study of two-month-old infants looking at an image of a woman's face activation of the infant's right brain. Here you see this is the PET scan of a two-month-old infant looking directly ahead at the face of a woman and you see lateralization, you see the right hemisphere posterior and anterior areas being activated. Actually those areas are in a critical period of growth. They're wiring up their circuits together and that wiring is being affected by the emotional stimulation coming from the smiling face of the mother. Second of all, the tone of voice. There are auditory prosodic communications. You see Telkemeyer in two-to-six-day-old neonates showing responses to show acoustic modulations are lateralized to the right hemisphere. And actually there are also other research showing that in the first week of life a baby's right brain is activated by music. Again, another form which has high emotional impact. You see in 2010 seven-month-old infants respond to emotional prosody - that is, the mother-ese used by the mother in the right superior temporal sulcus and they conclude, "This pattern of findings suggest that the temporal regions specialized in processing voices very early in development, and that already in infancy, emotions differentially modulate voice processing in the right hemisphere. Then one more. A study entitled "Prosodic Processing and Three-Month-Old Infants is Subserved by the Right Temporal Parietal Region." So this is a an image of an infant showing activation on the right side of the right temporal area. This infant is asleep and the mother is singing a lullaby and even in the sleep state you see again the right brain processing this information. And then lastly, this matter of touch between the mother and the infant - the tactile gestural. This is out of Ed Tronick's lab. Observing left-sided regulatory gestures when the infant is stressed, that is to say, in the laboratory when the infant is stressed by the still face, it's attempting to calm itself and soothe itself by using the left hand in gestures again, regulatory gestures. And so they say infants cope with the emotional distress caused by unresponsive mothers through self-regulation behaviors associated with a greater activation of the right hemisphere. In some, this finding supports the view that during a stressful condition, there is a state- dependent activation of the right hemisphere. So not only in the non-stress state but here particularly in the stress state and I'll speak more about this - the right hemisphere is dominant for the stress response at all points of the lifespan. Tronick concludes: "More generally these findings suggest that the right hemisphere is more involved in the social and biological functions regarding infant caregiver emotional bonding." And then citing my work and my colleague Dan Siegel. Now in order to regulate these infants right brain The crescendos and the decrescendos of the mother's affective state, actually of the mother's autonomic nervous system, is in empathic resonance with similar crescendos and decrescendos of the infant's internal states of bodily arousal. Because essentially what the mother is doing is regulating arousal states. The baby becomes securely attached again to the psycho-biologically-attuned caregiver who receives these right brain affective bodily-based communications and regulates these states of positive and negative arousal. Winnicott, the pediatrician-psychoanalyst British psychoanalyst, Donald Winnicott, said the main thing is a communication between the baby and the mother in terms of the anatomy and physiology of live bodies. So now, to my mind, the best iconic representation of attachment is this. This is more than just mind to mind. This is mind, brain, body to mind, brain, body. And here what you're seeing is that the relationship between the two of them is now co-regulating. Their central nervous systems, their autonomic nervous systems as vagal tone is rising here as cortisol is dropping as oxytocin is increasing etc. I'm sure we'll hear more about this from Sue Carter tomorrow, but also their immune systems are being co-regulated by these interactions. But, to take this further, it's now thought that the relational interaction, the dyadic interaction between the newborn and the mother constantly controls and modulates the mother's exposure to environmental stimuli, the newborn's exposure to environmental stimuli and thereby the mother is serving as a regulator of the developing individual's internal homeostasis. But in addition to that, the regulatory function of the newborn-mother interaction may be a central promoter to ensure the normal development and maintenance of synaptic connections during the establishment of functional brain circuits. Because remember these circuits now are wiring up during the critical period and she is influencing that. So in 1996 I suggested that the self-organization of the developing brain occurs in the context of a relationship with another self, another brain. So, essentially, here's what we're looking at - as the mother is downloading these programs into the baby's brain, into this mutual interaction. And remember the baby's brain at this point in time is now doubling in size in the first year of life. In 1996, in the journal Lancet, Sieratzki and Woll suggested the role of the right hemisphere is crucial in relation to the most precious needs of mothers and infants. In 1997 Chiron published a study, "The right brain hemisphere is dominant in human infants" and actually, in that study she argued that the right brain is dominant through the first three years of life. It is not until between three and four that the left becomes dominant. And also, as you see Allman, the strong and consistent predominance for the right hemisphere emerges postnatally as the infant now begins to be able to process prosodic communications, tactile communications etc. So you're setting up lateralization which is an evolutionary mechanism. And then lastly here, earlier maturation of the right hemisphere is now supported by anatomical and imaging evidence. And again, it starts prenatally. In 2009, Lenzi, in an fMRI study of mother-infant emotional communications, offered data quote "supporting the theory that the right hemisphere is more involved than the left hemisphere in emotional processing and thus mothering." And there are now some indications to show that if the mother is attempting to read the baby with her analytical, sequential left brain rather than her right brain, this may be associated more with the organization of insecure avoidant attachments because only the right can process these and put these into the body. In 2009, in the journal Cerebral Cortex, Japanese researchers Near-Infrared Spectroscopy Study of Infant-Mother Attachment at12 Months - "Our results are in agreement with that of Schore who addressed the importance of the right hemisphere in the attachment system." And that made my day. For the rest of the lifespan, as Bowlby said, these internal working models of attachment are established. The baby uses and we all use at later points in time these internal working models of attachment. And they are stored in implicit procedural memory. They're not stored in declarative linguistic semantic memory, but in the right brain in implicit procedural memory. This internal working model is used by all human beings as strategies of affect regulation that non-consciously guide us throughout life in various affectively charged environments. And that we use these mechanisms with all human beings, especially in intimate - that beneath the words that are going on, we're also reading the nonverbal communications that are being sent back and forth between us and actually now, this has now become a part of psychotherapy as psychotherapy is now again the pati..the therapist is reading beneath the words, so to speak, and attempting as Bowlby said to change the internal working models of an insecure to secure. Again, in all later stages of development this attachment representation again acting at levels beneath conscious awareness is access... access to appraise, interpret and regulate social emotional information. It is not done as well by the conscious left linguistics minds, as it is by the rational mind, as it is by the emotional brain and that this internal working model guides human interactions, especially in familiar and in novel interpersonal environments. Now, along the line, there have been a number of studies establishing also that optimal ability to regulate stress this is dependent upon right hemispheric specialization and regulating stress and emotion-related processes. There is very good evidence that when it comes to low levels of stress or moderate levels of stress, we use our left brains. But when it gets down to intense stress we shift right, into the right brain and we're tapping into our early internal working models that are based on our early experiences. So again, it's this right side of this chart you see the right hemisphere which is connected into the emotion-processing limbic system and into the brainstem, the regulation of arousal and pain system. It is that right vertical circuit, I'm suggesting, which is set up by the attachment. These adaptive right brain survival functions, and again, the survival functions are on the right, and that's why nature has literally set the right up first and then to the left, are initially imprinted in these right brain to right brain attachment communications during these early critical periods of infancy. And, as I alluded to before, because the brain growth spurts thoughts in the last trimester we're now looking at also working with mothers in, you know, in pregnancy, to begin to look at the establishment of emotional well-being in the infant. So here you see the mirror neuron researchers Dapretto, "Typically-developing children can rely upon a right hemisphere mirroring neural mechanism interfacing with the emotion-processing limbic system and the insula which is tied into the autonomic nervous system whereby the meaning of imitated or observed emotion is directly felt and hence understood." Another study by Uddin, "the emergent picture from the current literature seems to suggest a special role of the right hemisphere in self-related cognition" - essentially the idea of self, my own perception of self, in "own body perception", in the ability to read one's own body's cues, "in self-awareness" - being right brain and also "autobiographical memories", or history of our lives, so to speak. Not the narrative in the left but literally the emotional narrat...the emotional experiences are stored in the right brain. Which is why therapists are so interested now in the right brain. But, even more than that, the right hemisphere operates a distributed network for rapid responding to danger and urgent problems. The right preferentially processes environmental challenge, stress, and pain and manages self-protective responses such as avoidance and escape. Again, this is not the later linguistic left, this is the right. This is found, again, in all mammals. Emotionality is just the right brain's red phone compelling the mind to handle urgent matters without delay. And therefore, we're saying that a dysregulation of the right brain will be occurring in various fear-based psychopathologies. Lastly, Decety and Chaminade: "Mental states that are in essence private to the self may be shared between individuals," which is what psychotherapy is about. "Self-awareness, (notice) empathy, identification with others, and more generally inter subjective processes are largely dependent upon right hemisphere resources which are the first to develop." I want to speak very briefly now about affect dysregulation and when things go awry. I'm only going to touch on this very briefly. But in... Over the last two decades, I've also been interested in the problem of early psychopathogenesis - - about the early origins of psychiatric disorders and also treatment. So, here you see positive formation of emotional attachment, or negative maternal separation or loss, emotional experiences may carve a permanent trace into a still-developing neuronal network of immature synaptic connections, and thereby the early attachment relationship can either extend or limit the functional capacity of the brain during later stages of life. The best current description of the path of neural development is not that the brain, all brains are resilient, but that all brains are malleable. Again, for better or worse. So I'm listing very quickly, these are some of the fundamental survival functions of the right brain. If the left brain is involved in language functions and voluntary muscle movements etc., the lef...the right brain is involved in the communication, the processing of facial expressions, prosodies and gestures. Which, again, Roots of Empathy is focusing on these aspects of communication. The regulation of central and autonomic arousal because again in PTSD etc., what you're seeing is autonomic arousal dysregulation. The storage of implicit procedural emotional memory, the processing of novelty - it is now thought that novel...that familiar stimuli are processed by the left hemisphere, but novel stimuli, the ability to learn something new are processed by the right but, also threat and unexpected stimuli. In fact, the regulation of the human stress response and cortisol release also is processed in the right brain, and the reception and the expression and the communications of negative affects and pain. Indeed, the control of vital functions supporting survival and enabling the organism to cope actively and passively with stress by the right. And this is why, again, the right sets up early in development through the attachment relationship. The point I want to make here is that as opposed to the optimal situation that I alluded to first - if there is attachment trauma it's these functions that are impaired. In 2001, in the Infant Mental Health Journal I wrote an article in which I coined the term "The effects of early relational trauma on right brain development, affect regulation and infant mental health". And here I was really thinking not so much about trauma that comes from the physical environment as the trauma that comes from the emotional environment, when the primary caregiver, the haven of safety, is a source of not regulation but dysregulation. And so this relational attachment trauma interferes with the organization of these same cortical, subcortical, right brain, limbic, autonomic circuits. And it compromises, from infancy onward, the capacities, not only of attachment, but, also the capacity to play, and, notice, the capacity for empathy, and affect regulation. This imprints a permanent physiological reactivity of the right brain and a susceptibility to later disorders of affect regulation, expressed in a deficit, the capacity to cope with the kinds of stressors that come from human relationships. This is the work of the psychoanalyst Heinz Kohut. Now he's looking at adult patients who had early disturbances in attachment and he says, "If the mother's empathic ability has remained infantile, that is, if she tends to respond not with regulation but with panic to the baby's anxiety then a deleterious chain will be set into motion." Think about a context of abuse. "She may chronically wall herself off from the baby, thus depriving him of the beneficial effect of merging with her as she returns from experiencing mild anxiety to calmness." "Alternatively, she may continue to respond with panic, in which case two negative consequences may ensue," and again he's talking about here what if there is early abuse and neglect which would be again the most severe form of attachment trauma. "The mother may lay the groundwork in the child for a lifelong propensity toward the uncurbed spreading of anxiety or other emotions, or by forcing the child to wall himself off from such an overly intense and thus traumatizing experience..." A child now dissociates. "She may foster in the child an impoverished psychic organization. The psychic organization of a person who will later be unable to be empathic himself to other human beings, to experience human experiences, in essence, to be fully human." Again, empathy out of the attachment lies at the core of literally what it means to be human with other humans. So, the last part of this again, would move towards the repair of the self and here you see in 1990, in the Psychological Bulletin Semrud-Clikeman, "The emotional experiences of the infant develops through the sounds, images, and pictures that constitute much of an infant's early learning experience and are disproportionately stored or processed in the right hemisphere during the formative stages of brain ontogeny." Again, in implicit procedural memories, much of this at the subcortical level, much of this at the level of the right amygdala, the major fear center of the brain. The right hemisphere does enter into later growth state spurts, not quite as much as the first. And then the left comes into its growth spurt, also in the second year. The early forming right brain attachment system therefore can be shaped by later relationships I do not mean to say that this all sets up and then there's no plasticity. There is plasticity left in the system. If in childhood and adolescence an individual is exposed to emotional sensitivity in a caring, empathic relationship with another human being, usually someone older, the right brain can use this to build an attachment bond and this allows for further right brain development. Here you see the right first in a growth spurt then it goes left on the top of the graph but then it comes back. So there is plasticity in the system. And actually, in the attachment literature there is a term called earned secure attachments. These are people who are born with the worst of all possible beginnings, but then because of an important contact that they make with a human being who empathically can resonate with them and form a bond, they become earned secures and actually parent as secures. Actually psychotherapy is about the conversion of insecures into earned secures. So, I have suggested that this emotional right brain, and not the linguistic left, is dominant in psychotherapy. In 1909 Freud said psychotherapy is all about emotion fundamentally it's about emotion. So here we have Graeme Taylor, psychiatrist here in Toronto, who's done remarkable work on alexithymia: "Affect dysregulation is a fundamental mechanism of all psychiatric disorders." Actually let me say that this work on affect dysregulation and altering affect regulation is also the essential and important contribution of Bruce Perry who has worked on this same problem. Susan Bradley, here in Toronto, child psychiatrist: "All psychotherapies: psychodynamic, cognitive behavioral, experiential, interactional, show a similarity in promoting affect regulation." And so the relevance of these developmental attachment studies to the psychotherapeutic process lies in the commonality of the right brain to right brain emotional communications between the mother and the infant, and then later between the patient and the therapist. As the attachment now comes back expressed in the therapeutic alliance. And we now know, incidentally, that the major vector of improvement in psychotherapy is the therapeutic alliance. It's the relationship between the patient and the therapist, the emotional relationship that's at the core, much more than insight, just for the record. In current therapeutic models affects are the center of empathic communication, and the regulation of conscious and unconscious feelings is placed in the center of the clinical stage. Well, here you see my colleague Doug Watt, neuro-psychoanalyst: "Empathy has long been hypothesized as a critical, and possibly the most critical, outcome variable from the therapists' side and the therapeutic interaction in many schools of psychotherapy." And my colleague and core researcher Russell Mears in Australia: "The therapist's capacity for empathy is the principal agent of beneficial change in the patient." And I want to suggest that Roots of Empathy is also attempting to expand this right brain function in children and adolescents. I want to end with some thoughts again about this paradigm shift. The right brain and the relational unconscious. The shift is that we are not looking at two halves of one brain but two very separate processes. The British psychiatrist-neuroscientist Iain McGilchrist says that the differences between the two brain hemispheres is profound. "Each creates a coherent, utterly different and often incompatible versions of the world with competing priorities and values. Ultimately, if the left hemisphere is the hemisphere of what, The right hemisphere, with its preoccupation with context, especially relational context, the relational aspects of experience, emotion, and nuances of expression could be said to be the hemisphere of how." Again left and right and the truth of it is that the right frontal area is expanded on the left posterior is expanded on the left side. These are two different processors. He says, "If what one means by consciousness is the part of the mind that brings the world into focus, makes it explicit allows it to be formulated in language, and is aware of its own awareness, it is reasonable to link the conscious mind to activity, almost all of which lies ultimately in the left hemisphere. The right hemisphere, by contrast, yields a world of individual, changing, evolving interconnected, implicit, non-conscious incarnate living beings within the context of the lived world. But in the nature of things never fully graspable, always imperfectly known, and to this world it exists in a relationship of care. So McGilchrist says, now talking about the right brain, what are the characteristics of this right hemisphere and McGilchrist also makes the argument that we have become too left brain in our cultures. The idea, the title is "The Master and his Emissary", and the idea is that the right hemisphere is the master, the left hemisphere is the emissary and sometimes the left hemisphere, the emissary betrays the master. We have been too focused on left hemisphere, which is why I see Roots of Empathy as also as such a critical need at this point. So the right and not the left is dominant for and look where he starts again in empathy and intersubjectivity - the ability to read the minds of each other as the ground of consciousness. The importance of an open, patient attention to the world as opposed to a willful, grasping attention. The implicit or hidden nature of truth, the emphasis on process rather than stasis, the journey being more important than the arrival, the primacy of perception, the importance of the body, in constituting reality, an emphasis on uniqueness. Again the right domina for the objectifying nature of vision The irreducibility of all value to utility and creativity as an unveiling no-saying process rather than a willfully constructive process. Again this early developing right brain is shaped by attachment experiences. I thank you for your attention.